呼气 CT 肺动脉造影在减少吸气和屏气相关伪影中的应用：对比剂动力学及其对扫描方案的影响。
Use of expiratory CT pulmonary angiography to reduce inspiration and breath-hold associated artefact: contrast dynamics and implications for scan protocol.
机构信息
Department of Radiology, Bristol Royal Infirmary, Bristol, UK.
出版信息
Clin Radiol. 2011 Dec;66(12):1159-66. doi: 10.1016/j.crad.2011.06.012. Epub 2011 Sep 1.
AIM
To investigate the effects of scanning in expiration during computed tomography pulmonary angiography (CTPA).
MATERIALS AND METHODS
One hundred and eighty-one consecutive expiratory CTPA examinations were compared with 145 inspiratory CTPA examinations performed using a standardized protocol through assessment of attenuation seen in the cardiac chambers, pulmonary artery (PA), and ascending aorta.
RESULTS
Expiratory scans showed greater attenuation at the pulmonary trunk, right PA, left PA, lobar and segmental PAs (p<0.05). Expiratory scans showed a lower incidence of transient contrast medium interruption (p<0.001) and generalized unsatisfactory PA opacification (p<0.05). Scans with generalized low PA attenuation had lower attenuation in the right ventricle, left heart, and ascending aorta (p<0.001) suggesting that contrast medium delivery or dilution prior to contrast medium entry into the PA is responsible. Expiratory scans showed lower quality scores (p<0.001) for depiction of lung parenchyma.
CONCLUSION
Expiratory scanning could be used as an optimal protocol for dedicated PA imaging. However, it suffers from inferior parenchymal imaging and should probably be reserved for failed inspiratory breath-hold CTPA.
目的
研究在计算机断层肺动脉造影（CTPA）中呼气扫描的效果。
材料和方法
通过评估心脏腔室、肺动脉（PA）和升主动脉的可见衰减，比较了 181 例连续呼气 CTPA 检查和 145 例采用标准化方案进行的吸气 CTPA 检查。
结果
呼气扫描显示在肺动脉干、右肺动脉、左肺动脉、叶段和段肺动脉有更高的衰减（p<0.05）。呼气扫描显示短暂性对比剂中断的发生率较低（p<0.001）和广泛性不满意的 PA 显影（p<0.05）。具有广泛性低 PA 衰减的扫描显示右心室、左心和升主动脉的衰减较低（p<0.001），这表明在对比剂进入 PA 之前存在对比剂输送或稀释的问题。呼气扫描显示对肺实质的描绘质量评分较低（p<0.001）。
结论
呼气扫描可作为专用 PA 成像的最佳方案。然而，它存在较差的肺实质成像问题，可能应保留用于吸气屏气 CTPA 失败的情况。
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