Terasawa Kazuaki, Maruyama Atsunori, Tsukimata Tomohiro
Central Radiology Department, Nagano Red Cross Hospital, 5-22-1, Wakasato, Nagano-shi, Nagano, 380-8582, Japan,
Radiol Phys Technol. 2015 Jul;8(2):248-57. doi: 10.1007/s12194-015-0314-5. Epub 2015 May 1.
Contrast-enhanced CT employs a standard uniphasic single-injection method (SIM), wherein administration is based on two parameters: the iodine administration rate (mgI/s) and the injection duration (s). However, as the SIM uses a fixed iodine administration rate, only a uniform contrast enhancement can be achieved with this method. The iodine administration rate can be increased only by increasing the iodine dose or shortening the injection duration, and no arbitrary adjustments can be made to the peak enhancement characteristics of the time-enhancement curves (TECs) at the fixed injection parameters used in the SIM. To address this problem, we developed a variable injection method (VIM) with a new parameter, the variation factor (VF), to adjust the TECs. A phantom study with the VIM indicated that arbitrary adjustments to the iodine administration rate could be made without changing the injection duration or increasing the iodine load. In our study, VFs of 0.3 and 0.5, which showed earlier achievement of peak enhancements, showed better temporal separation between arterial vasculature and parenchyma or the venous vasculature than that obtained with the SIM. The higher peak enhancement provided by the VF of 0.3 was also considered to improve the contrast in qualitative diagnostic examinations. A VF of 0.5 increased the duration of the enhancement and was considered to produce stable enhancement of contrast in vascular investigations. The VF is now an essential parameter, and the VIM is useful as a reasonable contrast method that may contribute to both improved visualization and improvement in the accuracy of morphologic diagnosis.
对比增强CT采用标准的单相单次注射法(SIM),其中给药基于两个参数:碘给药速率(mgI/s)和注射持续时间(s)。然而,由于SIM使用固定的碘给药速率,用这种方法只能实现均匀的对比增强。碘给药速率只能通过增加碘剂量或缩短注射持续时间来提高,并且在SIM使用的固定注射参数下,无法对时间增强曲线(TEC)的峰值增强特征进行任意调整。为了解决这个问题,我们开发了一种可变注射法(VIM),引入了一个新参数——变化因子(VF)来调整TEC。一项使用VIM的体模研究表明,在不改变注射持续时间或增加碘负荷的情况下,可以对碘给药速率进行任意调整。在我们的研究中,VF为0.3和0.5时,峰值增强出现得更早,与SIM相比,动脉血管与实质或静脉血管之间的时间分离更好。VF为0.3时提供的较高峰值增强也被认为可改善定性诊断检查中的对比度。VF为0.5时增加了增强的持续时间,被认为在血管检查中可产生稳定的对比增强。VF现在是一个重要参数,VIM作为一种合理的对比方法很有用,可能有助于改善可视化并提高形态学诊断的准确性。