Kim Dae Jung, Kim Tae Hoon, Kim Sang Jin, Kim Dong Phil, Oh Chi Suk, Ryu Young Hoon, Kim Young Jin, Choi Byoung Wook
Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea.
Radiology. 2008 Jan;246(1):110-5. doi: 10.1148/radiol.2453061953.
To prospectively investigate the effect of the injection rate of a saline solution as a bolus chaser for the enhancement of the aorta and coronary arteries at multidetector computed tomographic (CT) coronary angiography.
Institutional review board approved this study, and all patients gave informed consent. One hundred consecutive patients (59 men, 41 women; mean age, 58 years +/- 11 [standard deviation]) underwent 64-section CT coronary angiography for coronary artery disease. They were divided into five groups (each group, n = 20) according to the injection rate of saline solution (3, 4, 5, 6, and 7 mL/sec). Iodinated contrast medium (60 mL) was injected intravenously at a rate of 4 mL/sec, followed by 60 mL saline solution administered intravenously at a rate of 3-7 mL/sec, depending on the groups. Attenuation values of the aortic root, right coronary artery, left anterior descending artery, and left circumflex artery were measured. Analysis of variance with the Scheffé method was used to evaluate statistical significance of the differences in attenuation according to the injection rate of saline solution.
The degree of contrast enhancement was affected by the injection rate of saline solution, and the attenuation values were higher as the injection rate increased up to 4-5 mL/sec (P < .05). The values plateaued at rates over 5 mL/sec in the aorta and over 4 mL/sec in the coronary arteries.
An injection rate of 4-5 mL/sec as a saline solution chaser is optimal for achieving maximum attenuation values of the aorta or coronary arteries by using 64-section CT with 60 mL contrast material.
前瞻性研究在多排螺旋计算机断层扫描(CT)冠状动脉造影中,作为团注追赶剂的生理盐水注射速率对主动脉和冠状动脉强化的影响。
机构审查委员会批准了本研究,所有患者均签署了知情同意书。连续100例患者(59例男性,41例女性;平均年龄58岁±11[标准差])因冠状动脉疾病接受64层CT冠状动脉造影。根据生理盐水的注射速率(3、4、5、6和7 mL/秒)将他们分为五组(每组n = 20)。以4 mL/秒的速率静脉注射碘造影剂(60 mL),随后根据分组情况以3 - 7 mL/秒的速率静脉注射60 mL生理盐水。测量主动脉根部、右冠状动脉、左前降支动脉和左旋支动脉的衰减值。采用Scheffé法进行方差分析,以评估根据生理盐水注射速率不同而导致的衰减差异的统计学意义。
造影剂增强程度受生理盐水注射速率影响,注射速率增加至4 - 5 mL/秒时衰减值更高(P < 0.05)。在主动脉中注射速率超过5 mL/秒以及在冠状动脉中注射速率超过4 mL/秒时,衰减值趋于平稳。
使用64层CT和60 mL造影剂时,作为追赶剂的生理盐水注射速率为4 - 5 mL/秒最有利于使主动脉或冠状动脉达到最大衰减值。