Godt Johannes Clemens, Eken Torsten, Schulz Anselm, Johansen Cathrine K, Aarsnes Anette, Dormagen Johann Baptist
1 Department of Radiology and Nuclear Medicine, Oslo University Hospital Ullevål, Oslo, Norway.
2 Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Acta Radiol. 2018 Sep;59(9):1038-1044. doi: 10.1177/0284185117752522. Epub 2018 Jan 19.
Background Split-bolus computed tomography (CT) is a recent development in trauma imaging. Instead of multiple scans in different contrast phases after a single contrast bolus, split-bolus protocols consist of one single scan of the thorax and abdomen after two or three contrast injections at different points of time. Purpose To evaluate and compare image quality and injury findings of a new triple-split-bolus CT (TS-CT) protocol of thorax and abdomen with those of a portal venous phase CT (PV-CT) in the same patient group. Material and Methods Trauma patients in 2009-2012 who underwent both the TS-CT initially and a PV-CT during the next six weeks were included. The TS-CT examination was performed as one CT run after application of three contrast boluses (total 175 mL) to enhance renal pelvis and urinary tract, the abdominal organs, and the large arterial vessels. The PV-CT had a fixed delay of 85 s. We measured attenuation in Hounsfield units (HU), evaluated possible organ injury and assessed image quality on a 5-point scale. Results Thirty-five patients were included. Attenuation measurements of major abdominal vessels, organs, and renal pelvis were significantly higher with the TS-CT protocol. Performance in organ injury diagnosis and image quality was equal in both protocols. Conclusion The overall performance of the TS-CT protocol is similar to the standard PV-CT. Excellent visualization of the arterial tree and the collecting system may eliminate the need for separate scans.
背景 分剂量团注计算机断层扫描（CT）是创伤成像领域的一项最新进展。分剂量团注方案并非在单次造影剂团注后进行不同对比期的多次扫描，而是在不同时间点进行两到三次造影剂注射后，对胸部和腹部进行一次扫描。目的 在同一患者组中评估和比较一种新的胸部和腹部三联分剂量团注CT（TS-CT）方案与门静脉期CT（PV-CT）的图像质量和损伤发现。材料与方法 纳入2009年至2012年间最初接受TS-CT检查且在接下来六周内接受PV-CT检查的创伤患者。TS-CT检查是在注入三次造影剂团注（共175 mL）后进行一次CT扫描，以增强肾盂和尿路、腹部器官以及大动脉血管。PV-CT有固定的85秒延迟。我们以亨氏单位（HU）测量衰减，评估可能的器官损伤，并以5分制评估图像质量。结果 纳入35例患者。TS-CT方案对主要腹部血管、器官和肾盂的衰减测量值显著更高。两种方案在器官损伤诊断和图像质量方面的表现相当。结论 TS-CT方案的总体表现与标准PV-CT相似。动脉树和集合系统的出色可视化可能无需进行单独扫描。
