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目的 研究正常肝脏与肝硬化肝脏在螺旋CT增强多期扫描中最佳对比剂剂量、注射流率及各组织强化达到峰值的时间。方法 正常肝脏、肝硬化肝脏各 6 0例 ,按完全随机设计法各分成 6组 ,分别以不同的注射剂量及流率在肘静脉注射非离子型对比剂 ,并在同一层面作连续多层扫描。最后测量各组织CT值 ,建立统计表并相互比较。结果 正常肝脏当注射剂量为 1 5ml/kg时 ,3种不同的注射流率除主动脉强化峰值两两比较统计学上差异均有显著性意义外 (P <0 0 5 ) ,门静脉、肝实质差异均无显著性意义 (P >0 0 5 ) ;当注射流率为 2 5ml/s时 ,不同的剂量强化峰值主动脉、门静脉、肝实质差异均有显著性意义 (P <0 0 5 )。肝硬化组 :当注射剂量为 2 0ml/kg时 ,3种不同的注射流率时肝实质在 2 5ml/s与 3 0ml/s时强化峰值差异有显著性意义 (P <0 0 5 )。当注射流率为3 0ml/s时 ,不同的剂量肝实质强化峰值差异有显著性意义 (P <0 0 5 )。结论 正常肝脏与肝硬化肝脏的螺旋CT增强扫描的最佳剂量、注射流率应分别为 1 5ml/kg、2 5ml/s和 2 0ml/kg、3 0ml/s。其主动脉、门静脉及肝实质达到峰值的时间分别为 :2 8s、5 2s、73s和 31s、6 8s、77s。
Objective To study the optimal contrast dose, the injection rate and the peak time of each tissue enhancement in normal liver and liver cirrhosis liver. Methods Sixty normal liver and liver cirrhosis patients were randomly divided into six groups according to a randomized design. Non-contrast contrast agents were injected into the cubital vein at different injection doses and flow rates, respectively. Continuous multi-layer scanning was performed on the same level . Finally, CT values of each tissue were measured, statistical tables were established and compared with each other. Results When the injection dose was 15ml / kg, there were significant differences among the three different injection rates except for the peak of aortic enhancement (P <0.05), and the difference of portal vein and liver parenchyma There was no significant difference between the two groups (P> 0.05). When the injection rate was 25ml / s, the differences of peak intensities of aorta, portal vein and hepatic parenchyma were significant (P <0.05) . In the cirrhotic group, when the injection dose was 20 ml / kg, there were significant differences (P <0.05) in peak intensification of hepatic parenchyma between 25ml / s and 30ml / s at three different injection rates. When the injection rate was 30ml / s, the difference of peak intensities of hepatic parenchyma at different doses was significant (P <0.05). Conclusion The optimal dose of helical CT in normal liver and liver cirrhosis should be 15ml / kg, 25ml / s and 20ml / kg respectively. The injection rate should be 30ml / s. The aorta, portal vein and liver parenchyma peak time were: 2 8s, 5 2s, 73s and 31s, 6 8s, 77s.