Feuerstein I M, Girton M E
Department of Radiology, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892.
Invest Radiol. 1989 Oct;24(10):776-80. doi: 10.1097/00004424-198910000-00010.
Four-hour delayed contrast-enhanced computed tomography (DCECT) shows promise for improved detection of focal liver lesions. No previous studies have examined the use of nonionic contrast materials for DCECT. The authors undertook a case-controlled study in monkeys to define the relative efficacies of iopamidol and diatrizoate for DCECT. In this model, diatrizoate made the liver significantly more opaque at four hours than did iopamidol (mean 126.5 vs 87.6 HU, P less than or equal to 0.05). Opacification of the gallbladder and biliary tract occurred more often and was denser with diatrizoate. The relative efficacies of biliary excretion correlate with similarities in molecular structure. While it has been shown that the increased density from DCECT with diatrizoate may allow detection of more metastatic lesions, the clinical utility of the inferior parenchymal density obtained with iopamidol, extrapolated to be approximately 11 to 14 HU in humans, remains to be-established.
四小时延迟增强计算机断层扫描（DCECT）在提高肝脏局灶性病变的检测方面显示出前景。此前尚无研究探讨非离子型对比剂在DCECT中的应用。作者对猴子进行了一项病例对照研究，以确定碘帕醇和泛影酸盐在DCECT中的相对效能。在该模型中，四小时时泛影酸盐使肝脏的显影明显比碘帕醇更浓密（平均126.5 HU对87.6 HU，P≤0.05）。使用泛影酸盐时，胆囊和胆道的显影更频繁且密度更高。胆汁排泄的相对效能与分子结构的相似性相关。虽然已表明使用泛影酸盐进行DCECT时密度增加可能有助于检测更多转移灶，但碘帕醇获得的较低实质密度（据推断在人类中约为11至14 HU）的临床效用仍有待确定。
