Nguyen Duy, Platon Alexandra, Shanmuganathan Kathirkamanathan, Mirvis Stuart E, Becker Christoph D, Poletti Pierre-Alexandre
Department of Radiology, Geneva University Hospital, 24 rue Micheli-du-Crest, Geneva 1211, Switzerland.
AJR Am J Roentgenol. 2009 Jan;192(1):3-10. doi: 10.2214/AJR.07.3702.
The purpose of this study was to compare a conventional multiregional MDCT protocol with two continuous single-pass whole-body MDCT protocols in imaging of patients with polytrauma.
Ninety patients with polytrauma underwent whole-body 16-MDCT with a conventional (n=30) or one of two single-pass (n=60) protocols. The conventional protocol included unenhanced scans of the head and cervical spine and contrast-enhanced helical scans (140 mL, 4 mL/s, 300 mg I/mL) of the thorax and abdomen. The single-pass protocols consisted of unenhanced scans of the head followed by one-sweep acquisition from the circle of Willis through the pubic symphysis with a biphasic (150 mL, 6 and 4 mL/s, 300 mg I/mL) or monophasic (110 mL, 4 mL/s, 400 mg I/mL) injection. Acquisition times and interval delays between head, chest, and abdominal scans were recorded. Contrast enhancement was measured in the aortic arch, liver, spleen, and kidney. Diagnostic image quality in the same areas was assessed on a 4-point scale.
Median acquisition times for the single-pass protocols were significantly shorter (-42.5%) than the acquisition time for the conventional protocol. No significant differences were found in mean enhancement values in the aorta, liver, spleen, and kidney for the three protocols. The image quality with both single-pass protocols was better than that with the conventional protocol in assessment of the mediastinum and cervical spine (p<0.05). There was no significant difference between the single-pass protocols.
Use of single-pass continuous whole-body MDCT protocols can significantly decrease examination time for patients with polytrauma and improve image quality compared with a conventional serial scan protocol. Monophasic injection with highly concentrated contrast medium can reduce injection flow rate and should therefore be preferred to a biphasic injection technique.
本研究旨在比较传统的多区域MDCT协议与两种连续单通道全身MDCT协议在多发伤患者成像中的应用。
90例多发伤患者接受了16层MDCT全身扫描，其中30例采用传统协议，60例采用两种单通道协议之一。传统协议包括头部和颈椎的平扫以及胸部和腹部的增强螺旋扫描（140 mL，4 mL/s，300 mg I/mL）。单通道协议包括头部平扫，随后从 Willis 环至耻骨联合进行一次扫描，采用双期（150 mL，6和4 mL/s，300 mg I/mL）或单期（110 mL，4 mL/s，400 mg I/mL）注射。记录头部、胸部和腹部扫描之间的采集时间和间隔延迟。测量主动脉弓、肝脏、脾脏和肾脏的对比增强。对相同区域的诊断图像质量进行4分制评估。
单通道协议的中位采集时间比传统协议的采集时间显著缩短（-42.5%）。三种协议在主动脉、肝脏、脾脏和肾脏的平均增强值方面未发现显著差异。在纵隔和颈椎评估中，两种单通道协议的图像质量均优于传统协议（p<0.05）。单通道协议之间无显著差异。
与传统的序列扫描协议相比，使用单通道连续全身MDCT协议可显著减少多发伤患者的检查时间并提高图像质量。使用高浓度对比剂的单期注射可降低注射流速，因此应优先于双期注射技术。
