Masuda Takanori, Nakaura Takeshi, Funama Yoshinori, Higaki Toru, Kiguchi Masao, Imada Naoyuki, Sato Tomoyasu, Awai Kazuo
From the *Department of Radiological Technology, Tsuchiya General Hospital, Nakajima-cho, Naka-ku; †Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima; ‡Department of Diagnostic Radiology, Graduate School of Medical Sciences, §Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, Kumamoto; and ∥Department of Diagnostic Radiology, Tsuchiya General Hospital, Nakajima-cho, Naka-ku, Hiroshima, Japan.
J Comput Assist Tomogr. 2017 Mar/Apr;41(2):309-314. doi: 10.1097/RCT.0000000000000513.
We evaluated the effect of the age, sex, total body weight (TBW), height (HT) and cardiac output (CO) of patients on aortic and hepatic contrast enhancement during hepatic-arterial phase (HAP) and portal venous phase (PVP) computed tomography (CT) scanning.
This prospective study received institutional review board approval; prior informed consent to participate was obtained from all 168 patients. All were examined using our routine protocol; the contrast material was 600 mg/kg iodine. Cardiac output was measured with a portable electrical velocimeter within 5 minutes of starting the CT scan. We calculated contrast enhancement (per gram of iodine: [INCREMENT]HU/gI) of the abdominal aorta during the HAP and of the liver parenchyma during the PVP. We performed univariate and multivariate linear regression analysis between all patient characteristics and the [INCREMENT]HU/gI of aortic- and liver parenchymal enhancement.
Univariate linear regression analysis demonstrated statistically significant correlations between the [INCREMENT]HU/gI and the age, sex, TBW, HT, and CO (all P < 0.001). However, multivariate linear regression analysis showed that only the TBW and CO were of independent predictive value (P < 0.001). Also, only the CO was independently and negatively related to aortic enhancement during HAP and to liver parenchymal enhancement when the contrast material injection protocol was adjusted for the TBW (P < 0.001).
By multivariate linear regression analysis only the TBW and CO were significantly correlated with aortic and liver parenchymal enhancement; the age, sex, and HT were not. The CO was the only independent factor affecting aortic and liver parenchymal enhancement at hepatic CT when the protocol was adjusted for the TBW.
我们评估了患者的年龄、性别、总体重（TBW）、身高（HT）和心输出量（CO）对肝动脉期（HAP）和门静脉期（PVP）计算机断层扫描（CT）时主动脉和肝脏对比增强的影响。
这项前瞻性研究获得了机构审查委员会的批准；168例患者均获得了参与研究的事先知情同意。所有患者均按照我们的常规方案进行检查；造影剂为600mg/kg碘。在CT扫描开始后5分钟内，使用便携式电动测速仪测量心输出量。我们计算了HAP期间腹主动脉的对比增强（每克碘：[增量]HU/gI）以及PVP期间肝实质的对比增强。我们对所有患者特征与主动脉和肝实质增强的[增量]HU/gI之间进行了单变量和多变量线性回归分析。
单变量线性回归分析显示，[增量]HU/gI与年龄、性别、TBW、HT和CO之间存在统计学显著相关性（所有P<0.001）。然而，多变量线性回归分析表明，只有TBW和CO具有独立的预测价值（P<0.001）。此外，当根据TBW调整造影剂注射方案时，只有CO与HAP期间的主动脉增强以及肝实质增强独立且呈负相关（P<0.001）。
通过多变量线性回归分析，只有TBW和CO与主动脉和肝实质增强显著相关；年龄、性别和HT则不然。当根据TBW调整方案时，CO是影响肝脏CT时主动脉和肝实质增强的唯一独立因素。
