多层螺旋CT 颈动脉成像中智能触发监测点的合理选择

周建军 周康荣 陈祖望 吴东 陈惠明 陈刚 陈锦 缪熙音
刘豪 陆秀良 许红莲 张利军
【摘要】 目的 比较4 处不同智能触发监测位置对多层螺旋CT( MSCT) 颈动脉成像的影响, 以
期获得颈动脉多层螺旋CT 血管成像( MSCTA) 合理的智能触发监测点。方法 通过排列区分组法随
机将120 例分入颈总动脉、主动脉弓升部、主动脉弓降部、肺动脉主干4 个监测组内, 根据120 条颈动
脉、颈静脉的3 段感兴趣区( ROI) 强化情况综合评价, 由2 位有经验的放射科医生盲法评价, 对比4 组
不同智能触发监测点对成像的影响。结果 30 例颈总动脉智能触发组中, 11 例触发失败, 19 例成
功; 30 例主动脉弓升部智能触发组中, 触发失败7 例, 23 例成功; 30 例主动脉弓降部智能触发和30 例
肺动脉主干智能触发组全部触发成功。颈总动脉、主动脉弓升部、主动脉弓降部和肺动脉主干各组触
发成功时分叉水平颈动脉强化值分别为318. 1、275. 8、301. 2、293. 9 HU, 邻近颈静脉的强化值分别为
88. 7、147. 4、257. 5、91. 7 HU; 触发失败时, 颈总动脉、主动脉弓升部强化值分别为279. 6、247. 4 HU;
邻近颈静脉的强化值分别为285. 4、74. 1 HU。结论 4 组比较, 肺动脉主干智能触发不仅成功率高,
且静脉回流程度最轻, 是颈动脉MSCTA 的理想触发点。
【关键词】 体层摄影术, X 线计算机; 颈动脉; 血管造影术; 诊断技术和方法
Corr elations of site of bolus with the image quality in mult iple detector -r ow spiral CT angiography of
car otid ar tery ZHOU Jian-jun, ZHOU Kang-rong, CHEN Zu-wang, WU Dong, CHEN Hui-ming,
CHEN Ga ng, CHEN J in, MIAO Xi-yin, LIU Ha o, LU Xiu-lia ng, XU Hong-lian, ZHANG Li-jun. Department
of Radiology, Zhongsha n Hospital, Fudan University, Shanghai 200032, China
【Abstra ct 】 Objective To get an ideal bolus site by comparing the effectiveness of different bolus
sites on the image quality of carotid artery MSCTA. Methods One hundred and twenty patients with or
without clinical signs underwent the MSCTA examination with different bolus sites including common carotid
artery, ascending aorta, descending aorta and common pulmonary artery in four groups ( 30 patients in each) ,
the volume data acquired was used for Maximum Intensity Projection( MIP) and Volume Rendering( VR) .
General evaluation of image quality and enhancement of 120 carotid artery and jugular veins was conducted
by two experienced radiological doctors. Comparative analysis was done among four groups of different bolus
sites. Result s Eleven of 30 cases of common carotid artery bolus and 7 of 30 of ascending aorta bolus were
triggered unsuccessefully; all of 30 descending aorta and 30 common pulmonary artery bolus were triggered
successfully; the carotid artery bifurcation level enhancement of common carotid artery, ascending aorta,
descending aorta and common pulmonary artery triggered successfully was 318. 1 HU, 275. 8 HU,
301. 2 HU, and 293. 9 HU, respectively, and the enhancement of jugular veins closed to the carotid artery
bifurcation level was 88. 7 HU, 147. 4 HU, 257. 5 HU, and 91. 7 HU, respectively. The carotid artery
bifurcation level enhancement of unsuccessful cases of the common carotid artery and the ascending aorta was
279. 6 HU, 247. 4 HU respectively, and the enhancement of jugular veins close to the carotid artery
bifurcation level was 285. 4 HU, 74. 1 HU respectively. Conclusion In group Ⅰ( common carotid artery as
bolus triggering sites) , there was less jugular vein circumfluence but more failure rates and limited scanning
range. In group Ⅱ( ascending aorta as bolus triggering sites) , circumfluence of jugular and artifacts became
obvious. In group Ⅲ( descending aorta as bolus triggering sites) , there was higher successful image but with
serious veinous circumfluence. In group Ⅳ( common pulmonary artery as bolus triggering sites) , the image
was satisfied and with least veinous circumfluence. The bolus site of common pulmonary artery is preferable.
【Key wor ds】 Tomography, X-ray computed; Carotid artery; Angiography; Diagnostic
techniques and procedures