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1、CT ApplicationsDec 11, 2010CTA 扫描质量控制及注意事项扫描质量控制及注意事项1专业课CT Applications, July 4, 2010Company Confidential影响影响CTA 扫描图像质量的因素扫描图像质量的因素扫描前准备扫描启动时间选择扫描时长与循环时间的匹配造影剂总量控制和注射速率匹配造影剂入路选择2CT Applications, July 4, 2010Company Confidential当我们再谈论注射参数时，存在一点争议：在CTA扫描时，选择右侧肘静脉还是左侧肘静脉, 尤其是颈动脉及肺动脉CTA建议从右侧肘静脉注射，因为如果从
2、左侧肘静脉注射，由于左侧无名静脉从三根毛血管前经过，会有造影剂浓度过高伪影.造影剂入路选择造影剂入路选择影响影响CTA 扫描图像质量的因素扫描图像质量的因素3CT Applications, July 4, 2010Company Confidential介绍肺动脉肺动脉 CTA常见的协议参数注射参数病例头颈部头颈部 CTA常见协议参数注射参数病例腹部，肾脏，下肢腹部，肾脏，下肢 CTA常见协议参数注射参数病例4CT Applications, July 4, 2010Company Confidential肺动脉肺动脉 CTA扫描扫描常见的扫描协议参数注射参数病例图像展示5CT Applic
3、ations, July 4, 2010Company Confidential肺动脉肺动脉CTA扫描扫描肺动脉肺动脉CTA扫描参数扫描参数61664iCThelicalhelicalhelicalhelicalCollimation6x1.516x1.564xo.625128x0.625Pitch0.9000.9380.9380.938Thickness0.90.90.90.9Increment0.450.450.450.45Kv120120120120Mas250250250250ResolutionstandardstandardstandardstandardRotation time
4、0.750.50.50.5FilterBBBBthreshold100-150100-150100-150100-1506CT Applications, July 4, 2010Company Confidential肺动脉肺动脉CTA注射参数注射参数传统的注射参数传统的注射参数80-100ml 造影剂部分病例也可以通过具体的计算公式给出造影剂总量350-370 mg/ml 造影剂可以得到最好的图像威斯派克 320 也可以使用，并能得到好的图像肘前静脉注射是首选的最佳注射位置4.0 5.0ml/sec 的注射速率有些医院曾经对体格较大的患者使用5.0 6.0ml/sec 注射双筒注射器注射效
5、果很好肺动脉肺动脉CTA扫描扫描7CT Applications, July 4, 2010Company Confidential传统肺动脉CTA检查监测点放置8CT Applications, July 4, 2010Company Confidential肺动脉栓塞病例造影剂用量较多，静脉干扰明显9CT Applications, July 4, 2010Company ConfidentialPhilips常用的肺动脉注射参数常用的肺动脉注射参数建议使用双筒注射器选择高浓度造影剂 (Isovue 370,Omnipaque 350)20-30ml 造影剂，30ml生理盐水4.0-5.0
6、ml/sec 右肘前臂静脉注射造影剂跟踪：ROI感兴趣区设置在头臂静脉或上腔静脉100-150 阈值肺动脉肺动脉CTA扫描扫描10CT Applications, July 4, 2010Company ConfidentialPhilips目前常用肺动脉CTA扫描方案监测点放置11CT Applications, July 4, 2010Company Confidential肺动脉图像纯肺动脉影像，无肺静脉伪影干扰纯肺动脉影像，无肺静脉伪影干扰12CT Applications, July 4, 2010Company Confidential头颈部头颈部CTA扫描扫描常见的扫描协议参数注
7、射参数图像展示14CT Applications, July 4, 2010Company Confidential头颈部头颈部CTA扫描扫描61664iCThelicalhelicalhelicalhelicalCollimation6x0.7516x0.7564xo.625128x0.625Pitch0.9000.9380.9380.938Thickness0.90.90.90.9Increment0.450.450.450.45Kv120120120120Mas250250250250ResolutionstandardstandardstandardstandardRotation t
8、ime0.750.50.50.5FilterBBBBthreshold100-150100-150100-150100-150头颅头颅 CTA 扫描参数扫描参数15CT Applications, July 4, 2010Company Confidential头颈部头颈部CTA扫描扫描颈部颈部 CTA 扫描参数扫描参数61664iCThelicalhelicalhelicalhelicalCollimation6x1.516x1.564xo.625128x0.625Pitch0.9000.9380.9380.938Thickness0.90.90.90.9Increment0.450.450
9、.450.45Kv120120120120Mas250250250250ResolutionstandardstandardstandardstandardRotation time0.750.50.50.5FilterBBBBthreshold100-150100-150100-150100-15016CT Applications, July 4, 2010Company Confidential头颈部头颈部CTA扫描扫描选择高浓度造影剂 (Isovue 370,Omnipaque 350)药量：iCT及64排CT：40-50ml 16排CT：90ml造影剂注射速率：4-5ml/sec右肘
10、前臂静脉注射ROI感兴趣区设置在主动脉弓下降主动脉一侧100-150 阈值自动最短延迟时间头颈部头颈部CTA 注射参数注射参数17CT Applications, July 4, 2010Company Confidential头颈部头颈部CTA扫描扫描头颈部头颈部CTA图像图像18CT Applications, July 4, 2010Company Confidential体部体部CTA扫描扫描常见的扫描协议参数注射参数图像展示19CT Applications, July 4, 2010Company Confidential主动脉主动脉CTA 扫描参数扫描参数61664iCTheli
11、calhelicalhelicalhelicalCollimation6x1.516x1.564xo.625128x0.625Pitch0.9000.9380.9380.938Thickness0.90.90.90.9Increment0.450.450.450.45Kv120120120120Mas250300250250ResolutionstandardstandardstandardstandardRotation time0.750.750.50.5FilterBBBBthreshold15015015015021CT Applications, July 4, 2010Compan
12、y Confidential主动脉CTA血管造影全主动脉及胸主动脉扫描：ROI感兴区设定在降主动脉上腹主动脉扫描：ROI感兴区设定在腹主动脉上.22CT Applications, July 4, 2010Company Confidential肾动脉肾动脉CTA扫描参数扫描参数61664iCThelicalhelicalhelicalhelicalCollimation6x0.7516x0.7564xo.625128x0.625Pitch0.9000.9380.9380.938Thickness0.90.90.90.9Increment0.450.450.450.45Kv1201201201
13、20Mas250300250250ResolutionstandardStandardstandardstandardRotation time0.750.750.50.5FilterBBBBthreshold15015015015023CT Applications, July 4, 2010Company Confidential肾动脉CTA血管造影注意事项：肾动脉CTA扫描必须憋气，否则会出现呼吸伟影，影响图像质量ROI感兴趣区设定在肾动脉水平处.24CT Applications, July 4, 2010Company Confidential下肢动脉下肢动脉 CTA 扫描参数扫描参
14、数61664iCThelicalhelicalhelicalhelicalCollimation6x1.516x1.564xo.62564x0.625Pitch0.9000.9380.760.76Thickness2211Increment110.70.7Kv120120120120Mas180180250250ResolutionstandardstandardstandardstandardRotation time0.750.750.750.75FilterBBBBthreshold15015015015025CT Applications, July 4, 2010Company Co
15、nfidential体部体部CTA检查的注射参数检查的注射参数高浓度造影剂（首选350 mgI/100ml或370 mgI/100ml造影剂)造影剂量：16排：主动脉，上、下肢动脉：90-100ml 64排：主动脉70ml，上、下肢动脉90-100ml iCT：主动脉50-60ml，上、下肢90ml注射速度：主动脉、肾动脉4-5ml/s，上、下肢动脉4ml/s阈值：150HU启动时间：主动脉、肾动脉选择自动最短延时 上肢到达阈值后延时8s扫描，下肢到达阈值后延 时12-15s启动扫描26CT Applications, July 4, 2010Company Confidential下肢动脉C
16、TA血管解剖Superficial FemoralPopliteal ArteryAnterior TibialPeroneal ArteryPosterior Tibial27CT Applications, July 4, 2010Company Confidential主动脉, 肾动脉和下肢动脉血管图像28CT Applications, July 4, 2010Company Confidential主动脉, 肾动脉和下肢动脉血管图像29CT Applications, July 4, 2010Company Confidential30CT Applications, July 4,
17、 2010Company Confidential31CT Applications, July 4, 2010Company Confidential下肢CTV直接法：造影剂稀释：造影剂： 生理盐水=1：5-6 足背静脉注射 稀释后造影剂总量80ml 注射速率1.5-2.0ml/s 使用Blous tracking，监测点至于下 腔静脉，阈值150 32CT Applications, July 4, 2010Company Confidential间接法： 手臂静脉注射 高浓度造影剂 总量：150ml 注射速率：3.0ml/s 延迟时间：150s 扫描方向：足侧-头侧33CT Applications, July 4, 2010Company Confidential门静脉CTV：造影剂总量：100-150ml，延迟时间45-50s下腔静脉CTV：造影剂总量：120-150ml，延迟时间65-75s3435
