Watanabe Jun, Endo Kanenori, Tanaka Yasutaka, Goto Keisuke, Urushibara Shoichi, Osaki Tomohiro, Tatebe Shigeru, Nakamura Seiichi, Hirooka Yasuaki, Ikeguchi Masahide
Department of Surgery, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan.
Department of Radiology, Tottori Prefectural Central Hospital, Tottori 680-0901, Japan.
Yonago Acta Med. 2020 Jan 24;63(1):47-54. doi: 10.33160/yam.2020.02.007. eCollection 2020 Feb.
Dynamic computed tomography (CT) angiography is useful for evaluating of hepatic vascularity. Although vasodilators increase hepatic blood flow, the utility of dynamic CT with vasodilators is unclear. Here we investigated the utility and safety of dynamic CT with vasodilators.
A prospective case-control radiographic evaluation using abdominal dynamic CT with and without vasodilator was performed at a single center between October 2015 and September 2016. We compared the CT values in Hounsfield units of the aorta; celiac artery; and common, right, and left hepatic arteries in the arterial phase and the main trunk; right and left branches of the portal vein; and right, middle, and left hepatic veins in the portal phase with and without vasodilators. The region of interest was set in each element of the liver vasculature. Four radiological technologists independently and visually compared the scores of the portal vein (P-score) and hepatic vein (V-score) on a 5-point scale with and without vasodilators.
The CT values of arteries and veins using vasodilators were significantly higher than those without vasodilators. With and without vasodilators, the -scores were 3.1 ± 1.2 and 4.0 ± 1.1 ( < 0.05) and the V-scores were 3.3 ± 1.4 and 4.3 ± 1.0 ( < 0.05). Only one patient with vasodilator use had transient hypotension and recovered immediately without medication.
Dynamic CT with vasodilators can provides better visualization of vascular structures.
动态计算机断层扫描(CT)血管造影有助于评估肝脏血管情况。尽管血管扩张剂可增加肝血流量,但动态CT联合血管扩张剂的效用尚不清楚。在此,我们研究了动态CT联合血管扩张剂的效用及安全性。
2015年10月至2016年9月期间,在单一中心进行了一项前瞻性病例对照影像学评估,使用腹部动态CT,分别在使用和不使用血管扩张剂的情况下进行。我们比较了主动脉、腹腔动脉以及肝总动脉、肝右动脉和肝左动脉在动脉期的亨氏单位CT值,以及门静脉主干、门静脉右支和左支以及肝右静脉、肝中静脉和肝左静脉在门静脉期的CT值,使用和不使用血管扩张剂的情况均进行比较。在肝脏血管系统的每个部位设置感兴趣区。四名放射技师独立地通过视觉比较了使用和不使用血管扩张剂时门静脉(P评分)和肝静脉(V评分)的五分制评分。
使用血管扩张剂时动脉和静脉的CT值显著高于不使用血管扩张剂时。使用和不使用血管扩张剂时,P评分分别为3.1±1.2和4.0±1.1(P<0.05),V评分分别为3.3±1.4和4.3±1.0(P<0.05)。仅一名使用血管扩张剂的患者出现短暂性低血压,未用药即迅速恢复。
动态CT联合血管扩张剂可更好地显示血管结构。