Schindera Sebastian T, Nelson Rendon C, DeLong David M, Jaffe Tracy A, Merkle Elmar M, Paulson Erik K, Thomas John
Department of Radiology, Duke University Medical Center, Box 3808, Erwin Rd, Durham, NC 27710, USA.
Radiology. 2007 May;243(2):438-44. doi: 10.1148/radiol.2432060534. Epub 2007 Mar 23.
To prospectively determine quantitatively and qualitatively the timing of maximal enhancement of the normal small-bowel wall by using contrast material-enhanced multi-detector row computed tomography (CT).
This HIPAA-compliant study was approved by the institutional review board. After information on radiation risk was given, written informed consent was obtained from 25 participants with no history of small-bowel disease (mean age, 58 years; 19 men) who had undergone single-level dynamic CT. Thirty seconds after the intravenous administration of contrast material, a serial dynamic acquisition, consisting of 10 images obtained 5 seconds apart, was performed. Enhancement measurements were obtained over time from the small-bowel wall and the aorta. Three independent readers qualitatively assessed small-bowel conspicuity. Quantitative and qualitative data were analyzed during the arterial phase, the enteric phase (which represented peak small-bowel mural enhancement), and the venous phase. Statistical analysis included paired Student t test and Wilcoxon signed rank test with Bonferroni correction. A P value less than .05 was used to indicate a significant difference.
The mean time to peak enhancement of the small-bowel wall was 49.3 seconds +/- 7.7 (standard deviation) and 13.5 seconds +/- 7.6 after peak aortic enhancement. Enhancement values were highest during the enteric phase (P < .05). Regarding small-bowel conspicuity, images obtained during the enteric phase were most preferred qualitatively; there was a significant difference between the enteric and arterial phases (P < .001) but not between the enteric and venous phases (P = .18).
At multi-detector row CT, peak mural enhancement of the normal small bowel occurs on average about 50 seconds after intravenous administration of contrast material or 14 seconds after peak aortic enhancement.
通过使用对比剂增强的多排螺旋计算机断层扫描（CT），前瞻性地定量和定性确定正常小肠壁最大强化的时间。
本符合健康保险流通与责任法案（HIPAA）的研究经机构审查委员会批准。在告知辐射风险信息后，从25名无小肠疾病史（平均年龄58岁；19名男性）且接受过单层动态CT检查的参与者处获得书面知情同意书。静脉注射对比剂30秒后，进行连续动态采集，包括以5秒间隔获取的10幅图像。随时间从小肠壁和主动脉获取强化测量值。三名独立阅片者对小肠的显影情况进行定性评估。在动脉期、肠期（代表小肠壁强化峰值）和静脉期分析定量和定性数据。统计分析包括配对t检验和采用Bonferroni校正的Wilcoxon符号秩检验。P值小于0.05表示有显著差异。
小肠壁强化峰值的平均时间为49.3秒±7.7（标准差），在主动脉强化峰值后13.5秒±7.6。强化值在肠期最高（P < 0.05）。关于小肠显影情况，肠期获取的图像在定性方面最受青睐；肠期和动脉期之间有显著差异（P < 0.001），但肠期和静脉期之间无显著差异（P = 0.18）。
在多排螺旋CT检查中，正常小肠壁的最大强化平均发生在静脉注射对比剂后约50秒或主动脉强化峰值后14秒。
