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目的:探讨不同注射流率下256层CT血管造影(CTA)显示脊髓Adamkiewicz动脉(AKA)的效果分析。方法:120例受试者按照对比剂注射流率随机分成3组,4 ml/s组、5 ml/s组和6 ml/s组,每组按照触发阈值200 HU和350 HU再分成2小组,每小组20例受试者。应用自动触发技术,达到阈值后延迟4 s开始扫描,所有CTA均由256层CT扫描机扫描,对比剂使用2 ml/kg,碘含量350 mgI/ml,通过18 G留置套管针肘前静脉注射,对原始数据进行容积重建(volume reformation,VR)、多平面重建(multiplanar reformation,MPR)和曲面重建(curved multiplanar reformation,CPR),由2位心血管影像诊断医师对结果进行分析。诊断标准:AKA在斜冠状位出现特征性的发夹征(hairpin sign),同时在血管CPR和3DVR显示AKA和主动脉之间的连续性确认。结果:4 ml/s 200 HU组确认7例,350 HU组6例;5 ml/s 200 HU组确认11例,350 HU组10例;6 ml/s 200 HU组确认19例,350 HU组确认18例,3组间AKA确认率有明显的统计学差异(P<0.01)。结论:在6 ml/s注射流率和200 HU或350 HU触发阈值扫描条件下,256层CT脊髓血管造影能够精确显示AKA和相应的节段性动脉,为临床提供可靠信息。
Objective: To investigate the effect of 256-slice CT angiography (CTA) on Adamkiewicz artery (AKA) in spinal cord under different injection rates. Methods: 120 subjects were randomly divided into 3 groups, 4 ml / s group, 5 ml / s group and 6 ml / s group according to contrast agent injection rate. Each group was subdivided into 2 subgroups according to 200 HU and 350 HU , 20 subjects in each subgroup. Automated triggering was used to start the scan after a delay of 4 s at the threshold and all CTAs were scanned by a 256-slice CT scanner using 2 ml / kg of contrast agent and 350 mgI / ml of iodine and 18 G of indwelling trocar in the antecubital vein The results were analyzed by two cardiovascular diagnostic physicians using volume reformation (VR), multiplanar reformation (MPR) and curved multiplanar reformation (CPR) of the raw data. Diagnostic criteria: AKA exhibits a characteristic hairpin sign at the oblique coronal level, while continuity of confirmation between AKA and the aorta is demonstrated in the vascular CPR and 3DVR. Results: 7 cases were confirmed in 4 ml / s 200 HU group and 6 cases were in 350 HU group. 11 cases were confirmed in 5 ml / s 200 HU group and 10 cases were in 350 HU group. 19 cases and 350 HU group were confirmed in 6 ml / s 200 HU group Confirmed 18 cases, 3 groups AKA confirmation rate was significantly different (P <0.01). Conclusions: 256-slice CT spinal angiography can accurately display AKA and corresponding segmental arteries at 6 ml / s injection rate and 200 HU or 350 HU triggering threshold scan, providing reliable information for clinical practice.