摘要
目的探讨低管电流(120 mA)条件下分次团注双期CT尿路成像(CTU)的可行性及临床应用价值。方法 60例有泌尿系临床症状拟行CTU检查的患者随机分为2组:试验组30例,管电流采用120 mA,行CT平扫及分2次团注对比剂后行实质-排泄期扫描;对照组30例,管电流为350 mA,行CT平扫及单次团注对比剂后行实质期及排泄期扫描。2组均在检查前静脉注射呋塞米10 mg。2名医师采用双盲法分别对2组实质期(实质-排泄期)肾实质图像进行影像质量评分(IQS),对排泄期(实质-排泄期)各段尿路进行显影评分(OS)并评估其显影率,记录所有病例有效剂量(ED)。结果试验组肾实质IQS低于对照组,但影像质量均满足诊断要求;2组比较各段尿路OS及显影率差异无统计学意义(P>0.05);试验组平均ED[(10.4±0.6)mSv]较对照组平均ED[(37.2±1.6)mSv]下降约72.16%,差异有统计学意义(p<0.01)。结论低管电流(120 mA)结合分次团注双期CTU并辅以小剂量利尿剂,可在显著降低辐射剂量的同时获得满足临床诊断要求的影像,且无需增加对比剂用量,具有良好的临床应用价值。
Objective To evaluate the feasibility and applied value of split-bolus 2-phase CT urography (CTU) with low-tube-current (120 mA). Methods Sixty patients with urinary tract symptoms clinically recruited in this study were divided into two groups. Experimental group:thirty of them underwent split-bolus 2-phase CTU consisted of plain CT scanning and nephrographic-excretory phase with tuber current of 120 mA. Control group: the other thirty patients underwent single-bolus 3-phase CTU consisted of plain CT scanning, nephrographic phase and excretory phase with tuber current of 350 mA. All patients were given Furosemide 10 mg by intravenous injection before CTU examination. Axial and reformatted CT images of the two groups were evaluated by two radiologists with double blind method. The image quality scores (IQS) of renal parenchyma of nephrographic (nephrographic-excretory) phase were assigned, the opacification score (OS) and opacification rate of each segment of urinary tract of excretory (nephrographic-excretory) phase were evaluated respectively. In addition, the effective dose (ED) was also recorded. Results The IQS of renal parenchyma of experimental group were significantly lower than control group, but all images quality could meet diag-nostic requirement. There was no statistical difference in the OS and the opacification rate of each segment of urinary tract between the two groups (P>0.05). The average value of ED of control group was (37.2 ±1.6) mSv. The average value of ED of experimental group was (10.4±0.6) mSv, reducing 72.16%intrinsic dose compared to control group (P<0.01). Conclusion Application of split-bolus 2-phase CT urography with a low-dose furosemide injection using tube current as 120 mA can decrease markedly the radiation dose, and the images are satisfactory for diagnosis, but do not need more iodinated contrast agent, which is of better option in clinic.
出处
《实用医学影像杂志》
2015年第6期468-471,共4页
Journal of Practical Medical Imaging
