64排与256排螺旋CT肺动脉造影诊断老年肺栓塞的对比
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摘要
目的分析探讨64排与256排螺旋CT在诊断老年肺栓塞(PE)的价值。方法收集2016年1月至2018年6月收治的66例老年PE的患者。按照随机数表法平均分为两组各33例。观察组使用GE公司Revolution 256排CT进行扫描,对照组使用美国GE-lightspeed 64排(128层)螺旋CT进行扫描。观察指标包括肺动脉主干、左肺动脉、右肺动脉、胸大肌的动态检测CT值,测量的背景噪声(BN)为主动脉噪声值。根据计算公式计算信号噪声比(SNR)、对比度噪声比(CNR)。同时比较检查时间、造影剂使用剂量。结果观察组与对照组的观察指标结果显示,肺动脉干CT值、左肺动脉CT值、右肺动脉CT值、胸大肌CT值、BN、SNR、CNR两组比较,差异均没有统计学意义(P>0.05)。256排螺旋CT诊断老年肺栓塞在检查时间[(3.29±1.24)s vs(7.56±1.07)s]和造影剂剂量[(4.77±1.38) mSv vs(5.86±0.94) mSv]使用上均少于64排螺旋CT,差异有统计学意义(P<0.01)。结论 64排与256排螺旋CT都能够很好的诊断PE,但256排螺旋CT缩短了检查时间,减少了造影剂的使用剂量。
Objective To investigate the value of 64-slice and 256-slice spiral CT pulmonary angiography in the diagnosis of pulmonary embolism(PE)in elderly patients.Methods A total of 66 elderly PE patients who received diagnosis from January 2016 to June 2018 were selected and divided into observation group and control group randomly(n=33,each).The observation group was scanned with GE Revolution 256-slice CT,while the control group was scanned with GE-lightspeed 64-slice spiral CT.The dynamic CT values of the main pulmonary artery,the left pulmonary artery,the right pulmonary artery and the pectoralis major muscle were observed.The measured background noise(BN) was the noise value of the main artery.Signal to noise ratio(SNR) and contrast to noise ratio(CNR) were calculated according to the calculation formula.At the same time,the examination time and the dosage of contrast agent were compared.Results There were no significant differences between two groups in the CT value of the main pulmonary artery,the left pulmonary artery,the right pulmonary artery and the pectoralis major muscle,BN,SNR and CNR(all P>0.05).Compared with control group,the examination time and contrast agent dosage were fewer in study group [(3.29±1.24)s vs(7.56±1.07)s,(4.77±1.38) mSv vs(5.86±0.94) mSv,all P<0.01].Conclusion Both 64-slice spiral CT and 256-slice spiral CT could diagnose PE well,but 256-slice spiral CT can shorten the examination time and reduce the dosage of contrast agent.
Objective To investigate the value of 64-slice and 256-slice spiral CT pulmonary angiography in the diagnosis of pulmonary embolism(PE)in elderly patients.Methods A total of 66 elderly PE patients who received diagnosis from January 2016 to June 2018 were selected and divided into observation group and control group randomly(n=33,each).The observation group was scanned with GE Revolution 256-slice CT,while the control group was scanned with GE-lightspeed 64-slice spiral CT.The dynamic CT values of the main pulmonary artery,the left pulmonary artery,the right pulmonary artery and the pectoralis major muscle were observed.The measured background noise(BN) was the noise value of the main artery.Signal to noise ratio(SNR) and contrast to noise ratio(CNR) were calculated according to the calculation formula.At the same time,the examination time and the dosage of contrast agent were compared.Results There were no significant differences between two groups in the CT value of the main pulmonary artery,the left pulmonary artery,the right pulmonary artery and the pectoralis major muscle,BN,SNR and CNR(all P>0.05).Compared with control group,the examination time and contrast agent dosage were fewer in study group [(3.29±1.24)s vs(7.56±1.07)s,(4.77±1.38) mSv vs(5.86±0.94) mSv,all P<0.01].Conclusion Both 64-slice spiral CT and 256-slice spiral CT could diagnose PE well,but 256-slice spiral CT can shorten the examination time and reduce the dosage of contrast agent.
引文
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[15] 张丽军,王蒨.肺动脉血栓栓塞症常用诊断技术及研究进展[J].中国医学影像学杂志,2013,21(1):51-55.
[16] Righini M,Robert-Ebadi H,Le Gal G.Diagnosis of acute pulmonary embolism[J].J Thromb Haemost,2017,15(7):1251-1261.
[17] Choi H,Krishnamoorthy D.The diagnostic utility of D-dimer and other clinical variables in pregnant and post-partum patients with suspected acute pulmonary embolism[J].Int J Emerg Med,2018,11(1):10.
[18] 杜云鹏.64排螺旋CT增强扫描肺动脉栓塞的诊断价值[J].医学信息,2013,26(5):323-324.
[19] 刘旭东.256层螺旋CT肺动脉造影应用于老年肺动脉栓塞诊断的临床价值[J].中国保健营养,2016,26(23):74.
[20] 符传刚,李岩.256层螺旋CT肺动脉造影在老年肺动脉栓塞诊断中的价值[J].中国老年学,2013,33(6):1276-1277.
[2] 宋文奇,赵梦华,陈海鱼.急性肺栓塞危险分层的研究进展[J].山东医药,2015,55(5):99-101.
[3] 李银平,华琦,秦俭,等.急性肺栓塞患者76例诊治分析[J].中国全科医学,2011,14(1):96-98.
[4] 孙源君,Khalid Bin Waleed,夏云龙.心房颤动与肺栓塞的关系及治疗[J].中国循环杂志,2018,33(3):307-309.
[5] 王蔚,王耀丽,周健.重症监护室术后并发急性肺栓塞患者的诊疗研究[J].重庆医学,2018,47(1):29-31,34.
[6] 徐琪,周瑞清,王红旗,等.老年肺栓塞早期诊断延误的影响因素研究[J].中国全科医学,2018,21(7):804-808.
[7] 张凤革,张晓静,郑文旭.老年急性肺栓塞患者肺部感染的临床特点与预后分析[J].中华医院感染学杂志,2014,24(8):1915-1916,1922.
[8] 李岚,罗天友.肺栓塞诊断的影像学研究进展[J].重庆医学,2014,43(27):3662-3665.
[9] Widimsky J Sr,Aschermann M.New ESC guidelines on the diagnosis and management of acute pulmonary embolism[J].Vnitr Lek,2015,61(3):236-243.
[10] Herzog C,Arning-Erb M,Zangos S,et al.Multi-detector row CT coronary angiography:influence of reconstruction technique and heart rate on image quality[J].Radiology,2006,238(1):75-86.
[11] 张文艳,赵静,周瑞臣,等.双低剂量在头颈部无迭代技术多层螺旋CT血管成像中的可行性[J].中国医学影像学杂志,2015,23(11):829-832.
[12] 陈艳明,王士雯,陈琪,等.老年肺栓塞的临床特点分析[J].中国综合临床,2006,22(12):1079-1080.
[13] 何建国,程显声.肺栓塞诊断与治疗的进展[J].中华结核和呼吸杂志,2000,23(9):563-565.
[14] 郭丹杰,胡大一,周伟荣,等.急性肺栓塞诊断治疗的临床分析及探讨[J].中华心血管病杂志,2003,31(1):49-51.
[15] 张丽军,王蒨.肺动脉血栓栓塞症常用诊断技术及研究进展[J].中国医学影像学杂志,2013,21(1):51-55.
[16] Righini M,Robert-Ebadi H,Le Gal G.Diagnosis of acute pulmonary embolism[J].J Thromb Haemost,2017,15(7):1251-1261.
[17] Choi H,Krishnamoorthy D.The diagnostic utility of D-dimer and other clinical variables in pregnant and post-partum patients with suspected acute pulmonary embolism[J].Int J Emerg Med,2018,11(1):10.
[18] 杜云鹏.64排螺旋CT增强扫描肺动脉栓塞的诊断价值[J].医学信息,2013,26(5):323-324.
[19] 刘旭东.256层螺旋CT肺动脉造影应用于老年肺动脉栓塞诊断的临床价值[J].中国保健营养,2016,26(23):74.
[20] 符传刚,李岩.256层螺旋CT肺动脉造影在老年肺动脉栓塞诊断中的价值[J].中国老年学,2013,33(6):1276-1277.