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目的优化椎、颈动脉螺旋 CT 血管成像(SCTA)增强时相,研究增强扫描最佳触发时间和扫描方法,提高椎、颈动脉的三维显示率。方法在对比剂密度监控智能扫描(smartPrep)组133例椎、颈动脉(87例椎动脉、46例颈动脉)SCTA检查中,于足背静脉团注350 mg I/ml 的碘海醇后,应用 SmartPrep 技术优化扫描时相、触发扫描序列完成数据采集,对照组113例同样采用足背静脉团注对比剂,以经验估计延迟18～22 s 后触发扫描,经图像重建和三维重组显示靶血管。结果所有 SmartPrep 组 SCTA (133例,100%)均获成功,其增强时相处于最佳(130例)和较佳(3例)的扫描时期内,靶血管密度阈值在整个扫描周期[(18±4)s]内持续在100 HU 以上,而实际增强扫描的启动时间个体差异明显(15～43 s),误差达28 s。靶血管平均密度[(161.4±2.0)HU]明显高于对照组[(133.3±2.2)HU],差异有统计学意义(t=-9.456,P<0.01)。SmartPrep 组显示满意率为97.74%(130/133),不满意率为2.26%(3/133),失败率为0。对照组显示满意率为76.11%(86/113),不满意率为22.12%(25/113)和失败率为1.77%(2/113)。结论智能扫描技术应用于对比剂密度的实时监控并及时触发增强扫描,能获得满意的增强时相。
Objective To optimize the enhanced phase of spiral CT angiography (SCTA) in vertebral and carotid arteries, and to study the optimal triggering time and scanning method for enhanced scanning and to improve the 3D display rate of vertebral and carotid arteries. Methods In the SCTA of 133 vertebral and carotid arteries (87 vertebral arteries and 46 carotid arteries) in smartPrep group, bolus 350 mg I / ml iohexol in the dorsalis pedis vein, Application of SmartPrep technology to optimize the scanning phase, triggering the scan sequence to complete the data acquisition, the control group of 113 cases also dorsal venous bolus contrast agent, with an estimated delay of 18 ~ 22 s after the trigger scan, the image reconstruction and three-dimensional reconstruction of the target vessel . Results All SmartPrep groups achieved a success rate of SCTA (133 cases, 100%) during the scan period when the enhancement was in the best (130 cases) and better (3 cases) and the target blood vessel density threshold in the whole scan period [(18 ± 4) s] for more than 100 HU, while the difference between the start-up time of actual enhanced scan was significant (15-43 s) with an error of 28 s. The average density of target vessel [(161.4 ± 2.0) HU] was significantly higher than that of the control group [(133.3 ± 2.2) HU], the difference was statistically significant (t = -9.456, P <0.01). The SmartPrep group showed a satisfactory rate of 97.74% (130/133), an unsatisfactory rate of 2.26% (3/133) and a failure rate of 0. The control group showed a satisfactory rate of 76.11% (86/113), unsatisfactory rates of 22.12% (25/113) and failure rates of 1.77% (2/113). Conclusions Intelligent scanning technology can be used in real-time monitoring of contrast medium density and triggering enhanced scanning in time to obtain a satisfactory enhancement phase.