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目的:初步探讨四阶段双流率注射法在16层螺旋CT冠状动脉成像中的应用价值。方法:将符合入组条件的80例临床拟诊冠心病患者随机分为A、B、C、D 4组,每组20例。将80 ml对比剂和50 ml生理盐水分成四阶段注射:第一阶段注射20 ml生理盐水(流率4 ml/s);第二阶段注射50 ml对比剂(流率4 ml/s);第三阶段注射30 ml对比剂(A组流率3.5 ml/s,B组流率3.0 ml/s,C组流率2.5 ml/s,D组流率2.0 ml/s);第四阶段注射20 ml生理盐水(流率同第三阶段)。分别测量4组主肺动脉、升主动脉根部、上腔静脉、右心室及室间隔的CT值,并进一步计算出后两者的差值。结果:4组主肺动脉和升主动脉根部的平均CT值差异无统计学意义(P>0.05);B组和C组的上腔静脉平均CT值及A、B组与C、D组的右心室-室间隔平均CT差值组间差异有统计学意义(P<0.05)。结论:在CT冠状动脉造影检查中,降低后半程对比剂及生理盐水注射速率既不影响冠状动脉的成像效果,也不明显影响对右冠状动脉的观察,而且可以更好地显示右心室心腔和左心室室壁。
Objective: To investigate the value of four-stage double-flow injection in 16-slice spiral CT coronary angiography. Methods: Eighty cases of clinically diagnosed CHD patients who met the inclusion criteria were randomly divided into A, B, C and D 4 groups, with 20 cases in each group. 80 ml of contrast medium and 50 ml of normal saline were divided into four stages: 20 ml normal saline (flow rate 4 ml / s) in the first stage, 50 ml contrast medium (4 ml / s flow rate) in the second stage, 30 ml of contrast agent was injected in three stages (flow rate 3.5 ml / s in group A, flow rate 3.0 ml / s in group B, flow rate 2.5 ml / s in group C and flow rate 2.0 ml / s in group D) ml saline (flow rate with the third phase). The CT values of the four main pulmonary arteries, ascending aorta root, superior vena cava, right ventricle and ventricular septum were measured, and the difference between the latter two was calculated. Results: There was no significant difference in average CT value between the four groups (P> 0.05). The mean CT value of superior vena cava in group B and group C was significantly higher than that in group A and B There was significant difference between the mean ventricular and interventricular septum CT differences (P <0.05). CONCLUSIONS: CT contrast-enhanced and saline injection rates did not affect the imaging results of the coronary arteries, nor did they significantly affect the observation of the right coronary artery in CT coronary angiography, but also better demonstrated right ventricular Cavity and left ventricular wall.