Arakawa Hiroaki, Kohno Tatsuo, Hiki Taro, Kaji Yasushi
Department of Radiology, Dokkyo Medical University, 880, Kita-Kobayashi, Mibu, Tochigi, 321-0293 Japan.
AJR Am J Roentgenol. 2007 Jul;189(1):156-61. doi: 10.2214/AJR.06.1240.
The objective of our study was to determine factors associated with enhancement on CT pulmonary angiography and CT venography.
Two hundred forty-two cases (83 men and 159 women; mean age, 63 years; age range, 21-92 years) underwent CT pulmonary angiography using a bolus-tracking technique; 189 cases subsequently underwent CT venography 3 minutes after the start of the contrast injection. Two different amounts of nonionic iodine contrast medium were administered: patients weighing > 50 kg who were undergoing both CT pulmonary angiography and CT venography received 450 mg I (group B), whereas all other patients received 300 mg I (group A). The enhancement of vessels was subjectively estimated using a four-point scale, and attenuation values were measured at predetermined levels. Multiple regression analyses were performed with attenuation as the dependent variable and patient age, sex, and weight; amount of contrast medium; scanning delay; and presence of embolism as the independent variables.
The scanning delay for CT pulmonary angiography ranged from 10 to 31 seconds (mean, 19 seconds; SD, 3.3). Subjective estimates of enhancement quality on CT venography were significantly better for group B than for group A (p < 0.001). Multiple regression analyses revealed that body weight and age were the only significant and consistent independent variables associated with enhancement of the pulmonary arteries. The amount of contrast medium, body weight, and scanning delay were the independent variables that were consistently associated with enhancement of the deep veins.
The bolus-tracking technique showed relatively small variations in the scanning delay time. Patient age, body weight, and the amount of contrast medium were the important factors associated with vessel enhancement in combined CT pulmonary angiography and CT venography.
本研究的目的是确定与CT肺动脉造影和CT静脉造影强化相关的因素。
242例患者（83例男性和159例女性；平均年龄63岁；年龄范围21 - 92岁）采用团注追踪技术进行CT肺动脉造影；其中189例在开始注射造影剂3分钟后进行CT静脉造影。给予两种不同剂量的非离子型碘造影剂：体重>50 kg且同时进行CT肺动脉造影和CT静脉造影的患者接受450 mg碘（B组），而所有其他患者接受300 mg碘（A组）。使用四点量表对血管强化进行主观评估，并在预定层面测量衰减值。以衰减为因变量，患者年龄、性别、体重、造影剂剂量、扫描延迟和栓塞情况为自变量进行多元回归分析。
CT肺动脉造影的扫描延迟时间为10至31秒（平均19秒；标准差3.3）。B组CT静脉造影强化质量的主观评估明显优于A组（p < 0.001）。多元回归分析显示，体重和年龄是与肺动脉强化相关的仅有的显著且一致的自变量。造影剂剂量、体重和扫描延迟是与深静脉强化始终相关的自变量。
团注追踪技术显示扫描延迟时间的变化相对较小。患者年龄、体重和造影剂剂量是联合CT肺动脉造影和CT静脉造影中与血管强化相关的重要因素。
