Cao Lizhen, Du Xiangying, Li Pengyu, Liu Yaou, Li Kuncheng
Department of Radiology, Xuanwu Hospital of Capital Medical University, Beijing, China.
Eur J Radiol. 2009 Mar;69(3):496-9. doi: 10.1016/j.ejrad.2007.11.028. Epub 2008 Mar 3.
To explore the feasibility of multiphase contrast-saline mixture with dual-flow injection technique for visualization of right ventricular (RV) cavity and interventricular septum (IVS) in 64-row multidetector computed tomography (MDCT) coronary angiography.
Twenty-four patients underwent coronary CT angiography (CTA) imaging with 64-row MDCT. In twelve patients (group A), 60 ml contrast medium (CM) bolus was followed by 40 ml saline, and in the other twelve patients (group B), 50 ml CM bolus was followed by 50 ml contrast-saline mixture at 60:40 ratio. The CM, saline and contrast-saline mixture flow rate were all 5.0 ml/s. Two experienced radiologists measured the CT values of ascending aorta, descending aorta, pulmonary artery and RV, rated the uniformity of RV cavity, the visualization of coronary arteries and IVS independently.
By Kappa test, agreement between the two radiologists was 0.93 and 0.86 concerning the CT value measurements and the grades of the three indexes, respectively. By t-test, the mean CT values of ascending aorta and descending aorta of the two groups had no statistical difference (t=1.459, P>0.05; t=1.619, P>0.05); while the mean CT values of pulmonary artery and RV cavity had statistical differences (t=8.316, P<0.05; t=10.372, P<0.05). By two-related rank sum test, according to the visualization of coronary arteries and the uniformity of RV cavity, there were no statistical differences (U=66.00, P>0.05; U=54.00, P>0.05); while according to the visualization of IVS, group B was better than group A (U=8.00, P<0.05).
In coronary CTA, a contrast-saline mixture after CM bolus can provide clear visualization of RV and IVS and LV without impairing coronary CTA image.
探讨在64排多层螺旋CT（MDCT）冠状动脉造影中采用多期对比剂-生理盐水混合液双流注射技术观察右心室（RV）腔及室间隔（IVS）的可行性。
24例患者接受64排MDCT冠状动脉CT血管造影（CTA）检查。12例患者（A组）先注射60 ml对比剂团注，随后注射40 ml生理盐水；另外12例患者（B组）先注射50 ml对比剂团注，随后注射按60:40比例混合的50 ml对比剂-生理盐水混合液。对比剂、生理盐水及对比剂-生理盐水混合液的流速均为5.0 ml/s。两名经验丰富的放射科医生分别测量升主动脉、降主动脉、肺动脉及右心室的CT值，独立对右心室腔的均匀性、冠状动脉及室间隔的显影情况进行评分。
通过Kappa检验，两名放射科医生在CT值测量及三项指标的分级方面的一致性分别为0.93和0.86。通过t检验，两组升主动脉和降主动脉的平均CT值无统计学差异（t = 1.459，P > 0.05；t = 1.619，P > 0.05）；而肺动脉和右心室腔的平均CT值有统计学差异（t = 8.316，P < 0.05；t = 10.372，P < 0.05）。通过两相关秩和检验，根据冠状动脉显影情况及右心室腔的均匀性，两组无统计学差异（U = 66.00，P > 0.05；U = 54.00，P > 0.05）；而根据室间隔显影情况，B组优于A组（U = 8.00，P < 0.05）。
在冠状动脉CTA中，对比剂团注后使用对比剂-生理盐水混合液可在不影响冠状动脉CTA图像质量的情况下清晰显示右心室、室间隔及左心室。
