Background Conventional computed tomography angiography （CTA） is time consuming, user-dependent and has poor image quality in skull base region. This study assessed the feasibility of a new method, dual energy CTA f...Background Conventional computed tomography angiography （CTA） is time consuming, user-dependent and has poor image quality in skull base region. This study assessed the feasibility of a new method, dual energy CTA for depicting the cerebral artery.Methods Phantom scan was done with head CTA sequences on dual source CT and 64 spiral CT for radiation dose calculation. Dual energy CTA was done with dual source CT on 36 patients who were suspected of having cerebral vascular disease. Three series axial images in 0.75 mm thick, 0.4 mm increment were acquired, which were named with 80 kV, 140 kV and merged images; 80 kV and 140 kV images were transferred into dual energy software, and maximum intensity projection （MIP） image was generated quickly by dual energy bone remove （DEBR group）; merged images were transferred into In Space software to acquire MIP image through manual conventional bone remove （CoBR group）. Post processing time and reading time were compared. Image qualities of the two groups were compared, mainly focusing on skull base segments of internal carotid artery and bone subtraction. ANOVA and SNK tests were applied for radiation dose comparison. Student＇s t test and Wilcoxon rank sum test were applied for assessing differences between data for significance. Cohen＇s kappa was used for interobserver agreement. Results Radiation dose of phantom scan showed dual energy CTA was between digital bone subtraction and conventional CTA. The post processing time and reading time were much shorter in DEBR than CoBR, and image quality in skull base was much higher in DEBR than CoBR （P〈0.01）. There was no significant difference for suprasellar vessels between two groups （P〉0.5）. Interobserver agreement for all vessel segments was excellent （kappa=0.97）. Conclusions Dual energy CTA is a reliable, new modality for depicting cerebral artery, overcoming the limitation of conventional CTA in the skull base region. It can save much time in post processing and reading than conventional C展开更多
目的探讨16层螺旋CT冠状动脉成像的技术方法并对成像质量的影响因素进行分析。方法对47例临床怀疑冠心病患者和3例植入冠状动脉支架患者进行16层螺旋CT冠状动脉成像,采用心脏平扫和经肘静脉以3 m l/s的速率注入100 m l对比剂增强扫描,...目的探讨16层螺旋CT冠状动脉成像的技术方法并对成像质量的影响因素进行分析。方法对47例临床怀疑冠心病患者和3例植入冠状动脉支架患者进行16层螺旋CT冠状动脉成像,采用心脏平扫和经肘静脉以3 m l/s的速率注入100 m l对比剂增强扫描,分别进行钙化积分分析和冠状动脉MPR、M IP、VRT三维重建,评价冠状动脉主干和各级分支的显示情况。结果在患者准备充分和扫描技术合理的情况下,螺旋CT冠状动脉成像对冠状动脉主干和主要分支的显示达到诊断要求。三维重建的图像质量受心脏和呼吸运动、回顾性门控技术选择、扫描参数的设置以及射线硬化效应的影响。结论螺旋CT冠状动脉成像对于冠状动脉疾病的诊断和术后复查具有很高的临床价值。在检查中充分准备和训练患者、选择合理的技术参数是获得高质量三维重建图像的重要因素。展开更多
目的探讨5 F Tiger Ⅰ导管塑形技术在复杂冠状动脉造影中应用的效果。方法本研究为单中心、单盲、随机、平行对照试验，连续入选2016年1月至2017年6月在成都医学院第一附属医院首次冠状动脉造影中采用5 F Tiger Ⅰ导管不能完成显影的研...目的探讨5 F Tiger Ⅰ导管塑形技术在复杂冠状动脉造影中应用的效果。方法本研究为单中心、单盲、随机、平行对照试验，连续入选2016年1月至2017年6月在成都医学院第一附属医院首次冠状动脉造影中采用5 F Tiger Ⅰ导管不能完成显影的研究对象159例。采用随机数字表法，将研究对象分为两组：对照组79例，采用6 F Judkins及Amplatz导管，经桡动脉途径行冠状动脉造影；试验组80例，采用5 F Tiger Ⅰ造影导管塑形技术，经桡动脉途径行冠状动脉造影。将复杂冠状动脉造影原因分为A、B、C 3类：A类为左、右冠状动脉起源异常；B类为左、右冠状动脉开口较常规开口高或低，或开口向下、向上；C类为升主动脉较长、较宽，或较短、较细。比较两组的冠状动脉造影情况及手术并发症。结果试验组在冠状动脉造影中的X线暴露时间[（4.17±1.67）min比（4.78±1.51）min，P=0.017]、X线剂量[230（175, 275）mGy比267（230, 321）mGy, P〈0.001]、对比剂剂量[（54.6±8.2）ml比（61.8±7.9）ml, P=0.001]、手术时间[21.6（18.9, 25.4）min比26.8（23.4, 31.4）min, P〈0.001]和使用的导管数量[（1.30±0.56）根比（2.47±0.57）根, P=0.001]均少于对照组。试验组与对照组的冠状动脉造影成功率差异无统计学意义[97.5%（78/80）比98.7%（78/79）,P=0.567]。试验组与对照组术中发生桡动脉痉挛[2.5%（2/80）比5.1%（4/79），P=0.396]和冠状动脉痉挛[1.3%（1/80）比3.8%（3/79），P=0.639]的比例差异均无统计学意义。在A和C类原因的研究对象中，两组之间的X线暴露时间、X线剂量和手术时间差异均无统计学意义（P均〉0.05），试验组使用的导管数量均少于对照组（P均〈0.01）。在C类原因的研究对象中，试验组使用的对比剂剂量少于对照组（P=0.001）。在B类原因的研究对象中，试验组的X线剂量、对比剂剂量、手术时间和使用的导管数�展开更多
目的:探讨MRI联合减影CTA在基底动脉尖综合征(top of the basilar syndrome,TOBS)诊断及治疗中的应用价值。方法:回顾性分析21例TOBS患者的MRI和减影CTA检查资料,观察MRI显示病变的分布范围、椎基底动脉血管流空状况、椎基底动脉血管结...目的:探讨MRI联合减影CTA在基底动脉尖综合征(top of the basilar syndrome,TOBS)诊断及治疗中的应用价值。方法:回顾性分析21例TOBS患者的MRI和减影CTA检查资料,观察MRI显示病变的分布范围、椎基底动脉血管流空状况、椎基底动脉血管结构。结果:梗死灶分布于两侧丘脑、中脑、小脑、枕叶、颞叶。呈对称性病变13例,单侧分布8例。椎动脉及基底动脉血流异常者14例。76.2%(16/21)的患者中存在椎动脉和基底动脉形态异常,13例表现为基底动脉尖部变细,38.1%(8/21)的患者为椎、基底动脉动脉瘤,5例椎、基底动脉减影CTA检查未见明显异常。结论:MRI联合减影CTA检查为临床提供较为完整的诊断信息,可以作为TOBS筛选和首选的诊断方法。展开更多
文摘Background Conventional computed tomography angiography （CTA） is time consuming, user-dependent and has poor image quality in skull base region. This study assessed the feasibility of a new method, dual energy CTA for depicting the cerebral artery.Methods Phantom scan was done with head CTA sequences on dual source CT and 64 spiral CT for radiation dose calculation. Dual energy CTA was done with dual source CT on 36 patients who were suspected of having cerebral vascular disease. Three series axial images in 0.75 mm thick, 0.4 mm increment were acquired, which were named with 80 kV, 140 kV and merged images; 80 kV and 140 kV images were transferred into dual energy software, and maximum intensity projection （MIP） image was generated quickly by dual energy bone remove （DEBR group）; merged images were transferred into In Space software to acquire MIP image through manual conventional bone remove （CoBR group）. Post processing time and reading time were compared. Image qualities of the two groups were compared, mainly focusing on skull base segments of internal carotid artery and bone subtraction. ANOVA and SNK tests were applied for radiation dose comparison. Student＇s t test and Wilcoxon rank sum test were applied for assessing differences between data for significance. Cohen＇s kappa was used for interobserver agreement. Results Radiation dose of phantom scan showed dual energy CTA was between digital bone subtraction and conventional CTA. The post processing time and reading time were much shorter in DEBR than CoBR, and image quality in skull base was much higher in DEBR than CoBR （P〈0.01）. There was no significant difference for suprasellar vessels between two groups （P〉0.5）. Interobserver agreement for all vessel segments was excellent （kappa=0.97）. Conclusions Dual energy CTA is a reliable, new modality for depicting cerebral artery, overcoming the limitation of conventional CTA in the skull base region. It can save much time in post processing and reading than conventional C
文摘目的探讨16层螺旋CT冠状动脉成像的技术方法并对成像质量的影响因素进行分析。方法对47例临床怀疑冠心病患者和3例植入冠状动脉支架患者进行16层螺旋CT冠状动脉成像,采用心脏平扫和经肘静脉以3 m l/s的速率注入100 m l对比剂增强扫描,分别进行钙化积分分析和冠状动脉MPR、M IP、VRT三维重建,评价冠状动脉主干和各级分支的显示情况。结果在患者准备充分和扫描技术合理的情况下,螺旋CT冠状动脉成像对冠状动脉主干和主要分支的显示达到诊断要求。三维重建的图像质量受心脏和呼吸运动、回顾性门控技术选择、扫描参数的设置以及射线硬化效应的影响。结论螺旋CT冠状动脉成像对于冠状动脉疾病的诊断和术后复查具有很高的临床价值。在检查中充分准备和训练患者、选择合理的技术参数是获得高质量三维重建图像的重要因素。
文摘目的:探讨MRI联合减影CTA在基底动脉尖综合征(top of the basilar syndrome,TOBS)诊断及治疗中的应用价值。方法:回顾性分析21例TOBS患者的MRI和减影CTA检查资料,观察MRI显示病变的分布范围、椎基底动脉血管流空状况、椎基底动脉血管结构。结果:梗死灶分布于两侧丘脑、中脑、小脑、枕叶、颞叶。呈对称性病变13例,单侧分布8例。椎动脉及基底动脉血流异常者14例。76.2%(16/21)的患者中存在椎动脉和基底动脉形态异常,13例表现为基底动脉尖部变细,38.1%(8/21)的患者为椎、基底动脉动脉瘤,5例椎、基底动脉减影CTA检查未见明显异常。结论:MRI联合减影CTA检查为临床提供较为完整的诊断信息,可以作为TOBS筛选和首选的诊断方法。
