64排螺旋CT肝脏血管成像最佳扫描时间的研究
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摘要
目的:研究64排螺旋CT(GE LightSpeed VCT,简称VCT或容积CT)肝脏血管成像(computed tomography angiography, CTA)的最佳扫描时间。
材料与方法:随机选取2005年10月至2006年2月因各种原因行上腹部VCT平扫及增强扫描检查的病例155例(男96例,女59例,年龄13～88岁,平均55.59岁)作为本课题研究对象。全部病例均先行腹部平扫,然后从肘正中静脉注入对比剂,在智能追踪技术(Smart Prep)对腹主动脉追踪下行肝动脉期(hepatic arterial phase, HAP)、门静脉期(portal venous phase, PVP)及肝静脉期(hepatic venous phase, HVP)扫描,并对其中25例腹主动脉和39例门静脉在增强扫描前分别进行了吸气并屏气状态下的小剂量同层动态测试法(Test Bolus)扫描试验。数据统计指标包括时间、CT值(或称密度)及血管分支级别等。应用VCT主机工作站与GE Advantage Windows 4.2工作站相互协同完成图像和数据的处理。将所有计量或计数指标输入SPSS12.0统计软件包及Microsoft Office Excel 2003进行统计学处理。按以下标准将155例分为正常组和疾病组两组。正常组包括正常肝脏、局灶性脂肪肝、少许肝脏小囊肿或小钙化、单个小血管瘤(≤3cm)以及对肝血流无影响的远处病变等病例;疾病组包括原发或继发性肝癌、肝硬化、弥漫性脂肪肝、多囊肝、多发血管瘤或单个大血管瘤(>3cm)、胰腺癌、肝内外胆管扩张、肝血
Objective: To study the optimal scanning time using 64-detector row helical computed tomography (GE LightSpeed VCT, VCT) in hepatic computed tomography angiography (CTA).
Materiels and Methods: From Oct 2005 to Feb 2006, a total of 155 patients (96 men, 59 women, range 13-88 years, mean age 55.59 years) underwent the upper abdomen VCT scans, and had both unenhanced and enhanced scans. The enhanced scans performed at HAP, PVP and HVP by using Smart Prep technique in the abdominal aorta after injected contrast materials from median cubital vein. Among of the cases, 25 cases underwent Test Bolus technique in the abdominal aortas and 39 cases underwent Test Bolus technique in the portal veins. The indices of statistic datum included time, CT values and grades of the hepatic vascular branches. The images and datum were treated by cooperating VCT and Advantage Windows 4.2 workstation. The values of measuring and counting were statistically analyzed by using the software of SPSS 12.0 and the Microsoft Office Excel 2003. The cases were grouped under two heads. The normal group included the normal liver, the focal adiposis
材料与方法:随机选取2005年10月至2006年2月因各种原因行上腹部VCT平扫及增强扫描检查的病例155例(男96例,女59例,年龄13～88岁,平均55.59岁)作为本课题研究对象。全部病例均先行腹部平扫,然后从肘正中静脉注入对比剂,在智能追踪技术(Smart Prep)对腹主动脉追踪下行肝动脉期(hepatic arterial phase, HAP)、门静脉期(portal venous phase, PVP)及肝静脉期(hepatic venous phase, HVP)扫描,并对其中25例腹主动脉和39例门静脉在增强扫描前分别进行了吸气并屏气状态下的小剂量同层动态测试法(Test Bolus)扫描试验。数据统计指标包括时间、CT值(或称密度)及血管分支级别等。应用VCT主机工作站与GE Advantage Windows 4.2工作站相互协同完成图像和数据的处理。将所有计量或计数指标输入SPSS12.0统计软件包及Microsoft Office Excel 2003进行统计学处理。按以下标准将155例分为正常组和疾病组两组。正常组包括正常肝脏、局灶性脂肪肝、少许肝脏小囊肿或小钙化、单个小血管瘤(≤3cm)以及对肝血流无影响的远处病变等病例;疾病组包括原发或继发性肝癌、肝硬化、弥漫性脂肪肝、多囊肝、多发血管瘤或单个大血管瘤(>3cm)、胰腺癌、肝内外胆管扩张、肝血
Objective: To study the optimal scanning time using 64-detector row helical computed tomography (GE LightSpeed VCT, VCT) in hepatic computed tomography angiography (CTA).
Materiels and Methods: From Oct 2005 to Feb 2006, a total of 155 patients (96 men, 59 women, range 13-88 years, mean age 55.59 years) underwent the upper abdomen VCT scans, and had both unenhanced and enhanced scans. The enhanced scans performed at HAP, PVP and HVP by using Smart Prep technique in the abdominal aorta after injected contrast materials from median cubital vein. Among of the cases, 25 cases underwent Test Bolus technique in the abdominal aortas and 39 cases underwent Test Bolus technique in the portal veins. The indices of statistic datum included time, CT values and grades of the hepatic vascular branches. The images and datum were treated by cooperating VCT and Advantage Windows 4.2 workstation. The values of measuring and counting were statistically analyzed by using the software of SPSS 12.0 and the Microsoft Office Excel 2003. The cases were grouped under two heads. The normal group included the normal liver, the focal adiposis
引文
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[1] Copel L, Sosna J, Weeks D, et al. Use of three-dimensional CT in the abdomen: a useful preoperative planning tool [J]. Surg-Technol-Int, 2003, 11: 71-78.
[2] Hiroshige S, Shimada M, Harada N, et al. Accurate preoperative estimation of liver-graft volumetry using three-dimensional computed tomography [J]. Transplantation, 2003, 75: 1561-1564.
[3] Sahani D, Mehta A, Blake M, et al. Preoperative hepatic vascular evaluation with CT and MR angiography: implications for surgery [J]. Rdiographics, 2004, 24: 1367-1380.
[4] Limanond P, Raman SS, Ghobrial RM, et al. Preoperative imaging in adult-to-adult living related liver transplant donors what surgeons want to know [J]. J Comput Assist Tomogr, 2004, 28: 149-157.
[5] Foley WD, Karcaaltincaba M. Computed tomography angiography: principles and clinical applications [J]. J comput Assist tomogr, 2003, 27: S23-S30.
[6] Fishman EK. CT angiography: clinical applications in the abdomen [J]. Rdiographics, 2001, 21: S3-S16.
[7] Sahani D, Saini S, Pena C, et a1. Using multidetector CT for preoperative vascular evaluation of liver neoplasms: technique and results [J]. AJR Am J Roentgenol, 2002, 179: 53-59.
[8] Matoba M, Kondou T, Yokota H, et al. Usefulness of a saline flush for intravenous 3-dimensional computed tomography portography using multidetector-row helical computed tomography [J]. J Comput Assist Tomogr, 2005, 29: 780-785.
[9] Matsumoto A, Kitamoto M, Imamura M, et al. Three-dimensional portography using multislice helical CT is clinically useful for management of gastric fundic varices [J]. AJR Am J Roentgenol, 2001, 176: 899-905.
[10] Cademartiri F, Lugt A, Luccichenti G, et al. Parameters Affecting Bolus Geometry in CTA: A Review [J]. J Comput Assist Tomogr, 2002, 26: 598-607.
[11] Saini S. Multi-detector row CT: principles and practice for abdominal applications [J]. Radiology, 2004, 233: 323-327.
[12] Byun JH, Kim TK, Lee SS, et al. Evaluation of the hepatic artery in potential donors for living donor liver transplantation by computed tomography angiography using multidetector-row computed tomography: comparison of volume rendering and maximum intensity projection techniques [J]. J Comput Assist Tomogr, 2003, 27: 125-131.
[13] Lee SS, Kim TK, Byun JH, et al. Hepatic arteries in potential donors for living related liver transplantation: evaluation with multi-detector row CT angiography [J]. Radiology, 2003, 227: 391-399.
[14] Tanikake M, Shimizu T, Narabayashi I, et al. Three-dimensional CT angiography of the hepatic artery: use of multi-Detector row helical CT and a contrast agent [J]. Radiology, 2003, 227: 883-889.
[15] Kim T, Murakami T, Hori M, et a1. Hypervascular hepatocellular carcinoma revealed by double arterial phase CT performed with single breath-hold scanning and automatic bolus tracking [J]. AJR Am J Roentgenol, 2002, 178: 899-904.
[16] Sandstede JJ, Tschammler A. Beer M, et a1. Optimization of automatic bolus tracking for timing of the arterial phase of helical liver CT [J]. Eur Radiol, 2001, 11: 1396-1400.
[17] Bae KT. Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model [J]. Radiology, 2003,227: 809-816.
[18] Murakami T, Kim T, Takamura M, et a1. Hypervascular hepatocellular carcinoma: detection with double arterial phase multidetector row helical CT [J]. Radiology, 2001, 218: 763-767.
[19] Fleischmann D, Rubin G, Bankier A, et al. Improved uniformity of aortic enhancement with customized contrast medium injection protocols at CT angiography [J]. Radiology, 2000, 214: 363-371.
[20] Kapoor V, Brancatelli G, Federle MP, et al. Multidetector CT arteriography with volumetric three-dimensional rendering to evaluate patients with metastatic colorectal disease for placement of a floxuridine infusion pump [J]. AJR Am J Roentgenol, 2003, 181: 455-463.
[21] Katyal S, Oliver JH III, Buck DG, et al. Detection of vascular complications after liver transplantation: early experience in multislice CT angiography with volume rendering [J]. AJR Am J Roentgenol, 2000, 175: 1735-1739.
[22] 钱农, 潘昌杰, 倪新初, 等. 多排CT三维血管成像在肝移植中的应用[J]. 世界华人消化杂志, 2005, 13: 120-123.
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[24] 王东, 张挽时, 熊明辉, 等. 螺旋CT门静脉血管造影扫描参数和成像方法的优化[J]. 医学影像学杂志, 2001, 11: 352-355.
[25] 刘玉林, 陈宪, 郑之青, 等. MSCT 血管成像中Boluspro技术的应用[J]. 放射学实践, 2004, 19: 756-759.
[26] 周良平, 郭青, 徐香玖, 等. 多层面螺旋CT肝脏双期增强技术的研究――造影剂量及团注造影剂跟踪技术的影响[J]. 中国临床医学影像杂志, 2001, 12: 416-418.
[27] 严 福 华 , 陈 刚 , 周 康 荣 , 等 . 螺 旋 CT 肝 脏 检 查 中 延 迟 时 间 的 选 择 ——SmartPreP技术的应用和评估[J]. 临床放射学杂志, 1998, 17: 339-341.
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