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目的初步探讨低剂量对比剂联合生理盐水在64层螺旋 CT 头颈血管成像中的应用。方法 40例患者行头颈 CT 血管成像(CTA),采用随机数字表法根据对比剂使用剂量将患者分成2组,低剂量组(A组):50 ml 对比剂+20 ml 生理盐水;对照组(B组):70 ml 对比剂。采用双盲法,由2名有经验的放射科医师分别独立进行评价分析。结果 (1)2名医师在颈动脉、颅底动脉环显示、静脉伪影以及 CT 值测量上的 Kappa 值分别为0.895、0.814、0.702、0.836。(2)在颈动脉的显示上,2组评分结果 A 医师分别为1.3、1.2分,B 医师分别为1.4、1.2分,2名医师 A、B 组之间的差异均无统计学意义(U 值分别为173、128,p 值均>0.05);在颅底动脉环的显示上,2组的评分结果 A 医师分别为1.4、1.2分,B 医师分别为1.2、1.2分,2名医师 A、B 组之间的差异均无统计学意义(U 值分别为160、106,P 值均>0.05);在注射侧锁骨下静脉、头臂静脉、腔静脉的伪影上,2组的评分结果 A 医师分别为1.3、2.1分,B 医师分别为1.2、1.9分,2名医师 A、B 组之间的差异均有统计学意义(U 值分别为75、82,P<0.05)。(3)2组各血管 CT 值的测量结果,A 医师分别为329.1、322.9、241.4、194.6 HU 和353.3、342.7、245.8、204.5 HU,B 医师分别为337.3、329.5、239.2、192.8 HU 和345.6、341.2、247.1、210.5 HU;2名医师2组之间差异均无统计学意义(t 值分别为0.298、0.233,P>0.05)。结论 64层螺旋 CT 进行头颈血管 CTA 检查时,应用低剂量对比剂联合生理盐水可获得良好的 CTA图像,能为临床医师提供可靠的诊疗依据。
Objective To investigate the application of low-dose contrast agent combined with saline in 64-slice spiral CT head-and-neck vascular imaging. Methods Forty patients underwent neck and neck CT angiography (CTA). The patients were divided into two groups according to the dose of contrast agent using random number table. The low dose group (A group): 50 ml contrast medium +20 ml saline; the control group Group B): 70 ml contrast agent. Double-blind method, by two experienced radiologist independent evaluation. Results (1) The kappa values of two physicians in the carotid artery, the skull base arterial rings, venous artifacts and CT values were 0.895,0.814,0.702,0.836 respectively. (2) In the carotid artery, the score of the two groups was 1.3 and 1.2 respectively, and the score of physicians B and B was 1.4 and 1.2 respectively. There was no significant difference between the two physicians in group A and group B (U Values were 173,128, p values were> 0.05); in the display of the skull base artery rings, the scores of the two groups were 1.4 and 1.2 respectively, and the B doctors were 1.2 and 1.2 respectively. The two physicians A , The difference between group B was not statistically significant (U values were 160,106, P values were> 0.05); injection in the subclavian vein, brachiocephalic vein, vena cava in the artifacts, the two groups of scores Results A physicians were 1.3,2.1 points, B physicians were 1.2,1.9 points, two physicians A, B were statistically significant differences (U values were 75,82, P <0.05). (3) The measurement results of the CT values of the two groups of blood vessels were: A physicians were 329.1,322.9,241.4,194.6 HU and 353.3,342.7,245.8,204.5 HU, respectively, and physicians B were 337.3,329.5,239.2,192.8 HU and 345.6 respectively, 341.2,247.1 and 210.5 HU respectively. There was no significant difference between the two physicians in the two groups (t = 0.298,0.233, P> 0.05). Conclusion 64-slice spiral CT coronary artery CTA examination, the application of low-dose contrast agent combined with saline to obtain a good CTA images, clinicians can provide a reliable basis for diagnosis and treatment.