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使用低剂量造影剂并辅以生理盐水冲管的64排螺旋CT冠状动脉造影:总注射量对血管衰减的影响

Coronary angiography by 64-detector row computed tomography using low dose of contrast material with saline chaser: influence of total injection volume on vessel attenuation.

作者信息

Yamamuro Masaki, Tadamura Eiji, Kanao Shotaro, Wu Yen-Wen, Tambara Keiichi, Komeda Masashi, Toma Masanao, Kimura Takeshi, Kita Toru, Togashi Kaori

机构信息

Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

J Comput Assist Tomogr. 2007 Mar-Apr;31(2):272-80. doi: 10.1097/01.rct.0000236422.35761.a1.

Abstract

OBJECTIVE

To assess the influence of total injection volume on thoracic great vessels and coronary arteries enhancement in 64-detector row computed tomography (CT) coronary angiography using low dose of contrast material.

METHODS

Sixty patients underwent cardiac CT (64 x 0.5 mm, 0.4 rot/s) using 40 mL of contrast material (350 mg of Iodine per milliliter) in 30 patients and 50 mL in 30 patients. Computed tomography densities (Hounsfield units) in ascending aorta, descending aorta, and main pulmonary artery were measured at every second with the time of CT data acquisition recorded in each reconstructed image. Computed tomography densities of proximal and distal coronary arteries were also measured. Differences in CT densities between 40 and 50 mL contrast material were assessed with the Student t test. In addition, the relation between the injection volume (mL) of contrast material per kilogram body weight and contrast enhancement in coronary arteries was studied.

RESULTS

The average attenuations in the ascending and descending aorta and coronary arteries were significantly lower in 40-mL group than in 50-mL group (<0.05). In addition, the average attenuations in the pulmonary artery were significantly lower in 40-mL group than 50-mL group (<0.01). Every patient with the total injection volume of more than 0.9 mL/kg body weight showed a contrast enhancement more than 250 Hounsfield units.

CONCLUSIONS

The reduction of total injection volume lowered the enhancement of thoracic great vessels and coronary arteries in 64-detector row cardiac CT. The injection volume of at least 0.9 mL/kg body weight was necessary for a steady contrast enhancement in coronary arteries.

摘要

目的

使用低剂量对比剂,评估64排计算机断层扫描(CT)冠状动脉造影中总注射量对胸段大血管和冠状动脉强化的影响。

方法

60例患者接受心脏CT检查(64×0.5mm,0.4转/秒),其中30例患者使用40ml对比剂(每毫升含350mg碘),30例患者使用50ml对比剂。在CT数据采集时记录每个重建图像的时间,每秒测量升主动脉、降主动脉和主肺动脉的计算机断层扫描密度(亨氏单位)。还测量了冠状动脉近端和远端的计算机断层扫描密度。采用Student t检验评估40ml和50ml对比剂之间CT密度的差异。此外,研究了每千克体重对比剂注射量(ml)与冠状动脉对比增强之间的关系。

结果

40ml组升主动脉、降主动脉和冠状动脉的平均衰减明显低于50ml组(<0.05)。此外,40ml组肺动脉的平均衰减明显低于50ml组(<0.01)。每个总注射量超过0.9ml/kg体重的患者对比增强均超过250亨氏单位。

结论

在64排心脏CT中,总注射量的减少会降低胸段大血管和冠状动脉的强化。冠状动脉稳定的对比增强需要至少0.9ml/kg体重的注射量。

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