贺迎花+陈伟斌+张惠英

[摘要] 目的 探讨256层螺旋CT脾动脉成像中应用低剂量高浓度对比剂的价值。 方法 选择行256层螺旋CT脾动脉成像患者100例，观察组50例采用高浓度对比剂碘普罗胺50 ml+生理盐水20 ml，对照组50例采用常规浓度对比剂碘海醇70 ml。根据CT造影图像评价两种不同浓度、不同剂量对比剂对脾动脉的显示效果。 结果 观察组的腹主动脉腹腔干水平、脾动脉中段及脾叶动脉CT值均高于对照组，差异有统计学意义（P＜0.05）。两组脾动脉各级分支显示率比较，差异有统计学意义（P＜0.05）。两组的脾动脉图像质量评分比较差异无统计学意义（P＞0.05）。 结论 将低剂量高浓度对比剂应用于256层螺旋CT脾动脉成像中是可行的，可以获得满意的脾动脉图像，满足诊断需要，并能降低不良反应的发生率。

[关键词] 多层螺旋CT；脾动脉成像；X线计算机体层摄影术；对比剂

[中图分类号] R81[文献标识码] A[文章编号] 1674-4721（2014）04（c）-0109-03

The application research of low dose and high concentration contrast medium in 256 layers spiral CT splenic artery imaging

HE Ying-hua CHEN Wei-bin ZHANG Hui-ying▲

CT Department of Hebei United University Affiliated to Hospital,Tangshan063000,China

[Abstract] Objective To explore the application value of imaging splenic artery using high concentrations and low dose of contrast agent with 256-slice CT. Methods 100 cases of patients with 256-slice CT angiography were selected,high concentration of contrast agent with iopromide 50 ml and saline 20 ml were used in observation group(50 cases),conventional concentration of contrast agent with iohexol 70 ml was used in control group(50 cases).The display of the splenic artery with two different concentration and different dose of contrast agent was evaluate based on the CT image. Results CT value of abdominal aorta celiac level,the middle lobe splenic artery and splenic artery in observation group was higher than that in control group respectively,with statistical difference(P＜0.05).The rate of splenic artery branch level in two groups was compared,with statistical difference(P＜0.05).Splenic artery image quality score in two groups was compared,with no statistical difference(P＞0.05). Conclusion High concentration and low-dose contrast agent applied in the splenic with multi-slice CT imaging artery can obtain satisfactory image splenic artery,meet diagnostic needs and can reduce the incidence rate of adverse reaction.

[Key words] Multi-slice spiral CT;Splenic artery imaging;X-ray computer tomography;Contrast agent

近几年腹腔镜脾切除术（laparoscopic splenectomy，LS）以创伤小、术中出血少、术后恢复快、住院时间短等优点得到广大临床外科医生的认可。LS更被认为是治疗特发性血小板减少性紫癜（idiopathic thrombocytopenic purpura，ITP）的“金标准”[1-2]，尤其是对于儿童ITP[3]。LS手术中最大的难题是对脾蒂血管的处理，如在术前对患者的脾动脉走行及解剖没有充分的了解，在术中对脾蒂血管处理不当，常会引起术中出血[4]，从而不得已转为开腹手术，对患者造成二次伤害，因此，在行LS前有必要了解脾动脉的分支、走行，对术前评估及术中处理具有重要的参考价值[5]。随着多层螺旋CT（multi-section spial CT，MSCT）球管旋转速度加快，扫描时间缩短，且无创、图像分辨力高，现已成为脾动脉造影的首选。……