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目的 :比较不同注射程序对肝脏增强效果的影响 ,探寻常规 CT及螺旋 CT肝脏增强检查的最佳造影剂注射程序。方法 :16 6名正常肝实质观察对象随机分为六组 ,分别以不同流速的程序从前臂静脉注入 6 0 %泛影葡胺 90 ml,从开始团注后 2 0 s以动态程序扫描肝脏。以兴趣区测量大血管及肝实质不同时间增强后的 CT值。结果 :不同注射程序对门静脉及肝实质强化峰值影响较小 (P<0 .0 5 ) ,但双相注射程序肝实质增强达峰值及平衡期起点的时间显著延长 ,阈值间期及时间 -密度曲线的 AUC在 10～ 40HU阈值均显著长于或高于单相注射程序 ,在 5 0～ 6 0 HU阈值以双相特高流速组最优 (P<0 .0 5 )。结论 :1.第一时相流速较快的双相中、高流速注射程序是常规三、四代 CT肝脏动态增强检查的最佳造影剂注射程序 ;2 .经改进的双相特高流速注射程序在螺旋CT肝脏增强检查中仍有较重要的价值。
OBJECTIVE: To compare the effects of different injection procedures on liver enhancement and to explore the best contrast injection procedure for routine CT and spiral CT liver enhancement. Methods Sixteen normal liver parenchyma subjects were randomly divided into six groups. 90 mL of 60% diatrizoate meglumine was injected intravenously from the forearm vein with different flow rates respectively. The liver was scanned by dynamic program 20 minutes after bolus injection. The area of interest was used to measure the CT value of the enlarged blood vessels and liver parenchyma at different times. Results: Different injection procedures had less effect on portal vein and hepatic parenchyma (P <0.05), but the peak of hepatic parenchymal enhancement and the beginning of balance period were significantly prolonged in biphasic injection procedure. Threshold interval and time-density The AUC of the curve is significantly longer or higher than that of the single phase injection program at 10-40 HU, and is best at the threshold of 50-600 HU with biphasic UHP (P <0.05). The first phase of the fast flow rate of two-phase, high-flow injection program is the best routine third and fourth generation CT enhanced liver contrast enhanced contrast agent injection program; 2. Improved biphasic ultra-high velocity injection Procedures in the spiral CT liver enhancement test is still more important value.