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低浓度碘对比剂在肾脏MSCT增强扫描中的可行性研究(1)
http://www.100md.com 2015年5月25日 中国当代医药2015年第15期
     [摘要] 目的 对比分析270、350 mg I/ml两种浓度碘对比剂在肾脏多层面CT(MSCT)增强扫描中的强化作用以探讨低浓度碘对比剂在肾脏增强扫描中的可行性。 方法 收集90例2012年9月~2014年5月本院疑似肾脏病变患者,随机分成A、B组,各45例,分别给予肾脏平扫和多期MSCT增强扫描,A组选用270 mg I/ml碘对比剂,B组选用350 mg I/ml碘对比剂,注射后18 s、30 s、80 s、3~5 min测量各期增强扫描腹主动脉、双肾动脉、双肾静脉、双肾皮质、双肾髓质、双肾盂的CT强化值并观察各组患者不良反应的发生情况。 结果 B组患者发热等不良反应发生率高于A组患者;B组患者腹主动脉、右肾动脉、左肾动脉、右肾静脉、左肾静脉、右肾皮质、左肾皮质、右肾髓质、左肾髓质、右肾盂、左肾盂CT强化值均高于A组患者,但差异均无统计学意义(P<0.05)。 结论 在相同注射速率条件下多层螺旋肾脏血管成像使用低浓度对比剂可以获得满意的图像,同时可以减轻对比剂的不良反应。

    [关键词] 低浓度碘;多层面CT;肾脏;可行性研究

    [中图分类号] R816.7 [文献标识码] A [文章编号] 1674-4721(2015)05(c)-0061-04

    [Abstract] Objective To compare and analyze the enhancement effects of the Iodine contrast agents with two different concentrations of 270 and 350 mg I/ml in the enhancement scan of renal multislice CT (MSCT),and to discuss the feasibility of the Iodine contrast agent with low concentration in the renal enhancement scan. Methods 90 patients suspected of nephropathy in our hospital from September 2012 to May 2014 were collected.They were randomly assigned to group A and group B,with 45 patients in each group.They were both given renal scan and multi-phase MSCT enhancement scan respectively.The group A was given the Iodine contrast agent of 270 mg I/ml,and the group B was given the Iodine contrast agent of 350 mg I/ml.CT enhancement values of the enhancement scan of abdominal aorta,bilateral renal artery,bilateral renal veins,bilateral renal cortex,bilateral renal medulla and bilateral renal pelvis in each phase 18 s,30 s,80 s,3-5 min after the injection were measured.Adverse effects in each group of patients were observed. Results Incidence of adverse events such as fever in the group B was higher than that in the group A;the CT enhancement values of abdominal aorta,right renal artery,left renal artery,right renal vein,left renal vein,right renal cortex,left renal cortex,right renal medulla,left renal medulla,right renal pelvis and left renal pelvis in the group B were all higher than those in the group A,but the differences were not statistically significant (P<0.05). Conclusion At the same flow of injection,contrast agent with low concentration applied in multislice renal angiography is able to acquire satisfactory image,and meanwhile it is able to reduce the adverse effects induced by the contrast agent.

    [Key words] Iodine with low concentration;MSCT;Kidneys;Feasibility study

    多层螺旋CT(multi-slice spiral CT,MSCT)可获得对比剂瞬时分布,实现亚秒、亚毫米容积采集数据高质量三维成像,对于肾脏疾病的诊断应用具有非常重要的意义。由于高浓度对比剂可以提高成像质量[1],同时也会引起毒性反应、过敏反应等[2],因此对比剂的优化使用一直是医学领域研究的热点。目前临床上低浓度对比剂的相关研究尚少[3]。本研究通过回顾性分析采用不同碘浓度对比剂对肾脏的强化作用,进而探讨低浓度碘对比剂在肾脏增强扫描中的可行性,现报道如下。 (曾令志 郝敬军)
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