周建軍 周康榮 陳祖望 吳東 陳惠明 陳剛 陳錦 繆熙音
劉豪 陸秀良 許紅蓮 張利軍
【摘要】 目的 比較4 處不同智能觸發監測位置對多層螺旋CT( MSCT) 頸動脈成像的影響, 以
期獲得頸動脈多層螺旋CT 血管成像( MSCTA) 合理的智能觸發監測點。方法 通過排列區分組法隨
機將120 例分入頸總動脈、主動脈弓升部、主動脈弓降部、肺動脈主干4 個監測組內, 根據120 條頸動
脈、頸靜脈的3 段感興趣區( ROI) 強化情況綜合評價, 由2 位有經驗的放射科醫生盲法評價, 對比4 組
不同智能觸發監測點對成像的影響。結果 30 例頸總動脈智能觸發組中, 11 例觸發失敗, 19 例成
功; 30 例主動脈弓升部智能觸發組中, 觸發失敗7 例, 23 例成功; 30 例主動脈弓降部智能觸發和30 例
肺動脈主干智能觸發組全部觸發成功。頸總動脈、主動脈弓升部、主動脈弓降部和肺動脈主干各組觸
發成功時分叉水平頸動脈強化值分別為318. 1、275. 8、301. 2、293. 9 HU, 鄰近頸靜脈的強化值分別為
88. 7、147. 4、257. 5、91. 7 HU; 觸發失敗時, 頸總動脈、主動脈弓升部強化值分別為279. 6、247. 4 HU;
鄰近頸靜脈的強化值分別為285. 4、74. 1 HU。結論 4 組比較, 肺動脈主干智能觸發不僅成功率高,
且靜脈回流程度最輕, 是頸動脈MSCTA 的理想觸發點。
【關鍵詞】 體層攝影術, X 線計算機; 頸動脈; 血管造影術; 診斷技術和方法
Corr elations of site of bolus with the image quality in mult iple detector -r ow spiral CT angiography of
car otid ar tery ZHOU Jian-jun, ZHOU Kang-rong, CHEN Zu-wang, WU Dong, CHEN Hui-ming,
CHEN Ga ng, CHEN J in, MIAO Xi-yin, LIU Ha o, LU Xiu-lia ng, XU Hong-lian, ZHANG Li-jun. Department
of Radiology, Zhongsha n Hospital, Fudan University, Shanghai 200032, China
【Abstra ct 】 Objective To get an ideal bolus site by comparing the effectiveness of different bolus
sites on the image quality of carotid artery MSCTA. Methods One hundred and twenty patients with or
without clinical signs underwent the MSCTA examination with different bolus sites including common carotid
artery, ascending aorta, descending aorta and common pulmonary artery in four groups ( 30 patients in each) ,
the volume data acquired was used for Maximum Intensity Projection( MIP) and Volume Rendering( VR) .
General evaluation of image quality and enhancement of 120 carotid artery and jugular veins was conducted
by two experienced radiological doctors. Comparative analysis was done among four groups of different bolus
sites. Result s Eleven of 30 cases of common carotid artery bolus and 7 of 30 of ascending aorta bolus were
triggered unsuccessefully; all of 30 descending aorta and 30 common pulmonary artery bolus were triggered
successfully; the carotid artery bifurcation level enhancement of common carotid artery, ascending aorta,
descending aorta and common pulmonary artery triggered successfully was 318. 1 HU, 275. 8 HU,
301. 2 HU, and 293. 9 HU, respectively, and the enhancement of jugular veins closed to the carotid artery
bifurcation level was 88. 7 HU, 147. 4 HU, 257. 5 HU, and 91. 7 HU, respectively. The carotid artery
bifurcation level enhancement of unsuccessful cases of the common carotid artery and the ascending aorta was
279. 6 HU, 247. 4 HU respectively, and the enhancement of jugular veins close to the carotid artery
bifurcation level was 285. 4 HU, 74. 1 HU respectively. Conclusion In group Ⅰ( common carotid artery as
bolus triggering sites) , there was less jugular vein circumfluence but more failure rates and limited scanning
range. In group Ⅱ( ascending aorta as bolus triggering sites) , circumfluence of jugular and artifacts became
obvious. In group Ⅲ( descending aorta as bolus triggering sites) , there was higher successful image but with
serious veinous circumfluence. In group Ⅳ( common pulmonary artery as bolus triggering sites) , the image
was satisfied and with least veinous circumfluence. The bolus site of common pulmonary artery is preferable.
【Key wor ds】 Tomography, X-ray computed; Carotid artery; Angiography; Diagnostic
techniques and procedures