Application Value of Personalized Contrast Agent Injection Schemes of Different Durations in Pulmonary Artery CTA
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摘要:
目的：研究不同时长的个性化对比剂注射方案在提升肺动脉CTA的图像质量和降低对比剂潜在风险的应用价值。资料与方法：2023年1月至2024年10月临床怀疑为肺动脉栓塞的患者106例作为研究对象,随机将患者分配到A、B两组。采用独立样本t检验，比较两组间的上腔静脉的CT值、肺动脉主干的CT值、左肺动脉及右肺动脉的CT值、左房的CT值；两组间的图像质量主观的综合评分；以P < 0.05为具有统计学意义。结果：两组间对比剂注射总量、注射时长和注射速率进行比较，B组对比剂的注射总量和注射时长都低于A组，其差异有统计学意义。两组间的右肺动脉、左肺动脉、左房CT值比较接近，无统计学差异，两组间的上腔静脉CT值差异有统计学差异；两组间的图像质量主观评分比较，有统计学差异，B组＞A组。结论：采用8s时长的个性化对比剂注射方案不仅可以提高肺动脉CTA的总体图像质量，还可以有效减少对比剂用量，同时缩短注射时长。
Abstract:Objective: This study investigated the application value of personalized contrast agent injection schemes of different durations in improving the image quality of pulmonary artery CTA and reducing the potential risk associated with contrast agents. Materials and Methods: From January 2023 to October 2024, 106 patients with suspected pulmonary embolism were randomly assigned to Groups A and B. Using the independent samples t-test, we compared the CTA values of the superior venae cavae, pulmonary artery trunks, left and right pulmonary arteries, and left atria of the two groups. We also compared the subjective comprehensive evaluations of the CTA image quality of the two groups; a value of P<0.05 was considered statistically significant. Additionally, the two groups were compared in terms of the total amount of contrast agent injection, injection duration, and injection rate. Both the total amount and duration of contrast agent injection in Group B were lower than those in Group A; the concomitant difference was statistically significant. The CTA values of the right and left pulmonary arteries and the left atria of the two groups were relatively close, with no statistically significant difference. However, a statistically significant difference in the CTA values of the superior venae cavae of the two groups was observed. The subjective evaluation of image quality between the two groups indicated a statistically significant difference (P=0.04), with the image quality of Group B being higher than that of Group A. Conclusion: The use of an 8s personalized contrast agent injection regimen can not only improve the overall image quality of pulmonary artery CTA but also reduce the amount of contrast agent used and shorten the injection duration.
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图 1 A组注射方案的VR、MIP、MPR及横断位图
注：患者体重：60 kg，对比剂总量：36 mL，注射流速：3.6 mL/s。图像显示：肺动脉主干、左右动脉及其第5~6级细小肺动脉血管显示清晰，5分；上腔静脉内见少量对比剂潴留，横断位上腔静脉内对比剂有放射状伪影-1分，综合评分：4分。
Figure 1. VR, MIP, MPR, and cross-sectional map of injection regimen of Group A
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图 2 B组注射方案的VR、MIP、MPR及横断位图
注：患者体重：63 kg，对比剂总量：30 mL，注射流速：3.8 mL/s。图像显示：肺动脉主干、左右动脉及其第5~6级细小肺动脉血管显示清晰，评分5分，上腔静脉内见密度较淡对比剂，横断位上腔静脉内对比剂未见放射状伪影，0分，综合评分：5分。
Figure 2. VR, MIP, MPR, and cross-sectional map of injection regimen of Group B
表 1 两组不同时长的个性化注射方案的一般情况比较
Table 1 General comparison of two personalized injection regimens with different durations
项目 组别 统计检验 A组 B组 t P 男/女 23/31 29/23 2.77 0.74 年龄/Y 68.94±17.99 71.10±12.84 0.73 0.67 身高/mm 165.70± 8.24 166.98± 8.80 2.25 0.07 体重/kg 62.61±10.57 65.62±12.83 0.58 0.10 肺栓塞阳性/阴性 13/41 11/41 0.23 0.32 
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表 2 两组不同注射方案的图像质量比较
Table 2 Comparison of image quality between two different injection schemes
指标 分组 统计检验 A组 B组 t P 注射总量 40.74±4.43 34.42±3.05 4.13 0.01 注射时长 10.00±0.00 8.00±0.00 7.37 0.00 注射速度 4.07±0.44 4.10±0.37 12.63 0.06 上腔静脉CT值 740.02±542.05 460.54±211.20 7.60 0.00 肺动脉主干CT值 388.41±79.06 368.21±81.23 0.20 0.88 右肺动脉CT值 357.56±72.35 358.92±93.47 0.41 0.10 左肺动脉CT值 361.96±71.46 358.29±95.23 0.84 0.10 左房CT值 175.06±73.78 196.13±69.39 2.85 0.46 图像主观评分 4.12±0.74 4.59±0.73 1.77 0.04
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