比較半劑量與正常劑量對比劑在頸部磁振血管造影之初步評估

本研究探討利用磁振造影儀之TRICKS (Time-resolved imaging of contrast kinetics,多相位立體動態成像技術)，配合施打Gd-BOPTA(Gadobenate dimeglumine, 釓貝酸二葡甲胺)半劑量對比劑對頸部動脈血管影像品質是否有顯著影響。連續收集從民國102年3月1日至10月31日至本院執行頸部磁振血管造影受檢者，有40位病人因GFR(glomerular filtration rate腎絲球過濾率)值落於31-60，給予半劑量；另隨機抽取40位病人施打正常劑量；針對兩組病人分析血管CNR(contrast to noise ratio對比雜訊比)與SNR(signal to noise ratio訊雜比)；2位放射專科醫師在雙盲情況下進行影像品質判讀與比較。40位給予正常劑量之病人成功取得動脈相，40位給予半劑量之病人，有一位顯影較不飽和，但仍可判讀；兩位醫師再不被告知的情況下進行判讀，兩組病人影像品質並無明顯差距；施打正常劑量病人的血管SNR＆CNR分析均高於半劑量。利用TRICKS技術，半劑量對比劑並沒有影響頸部血管磁振造影檢查影像品質及判讀；對於腎臟功能不佳之病患，減少劑量對於誘發腎因性全身皮膚硬化症相對減少。

關鍵字

半劑量對比劑；三維時間分辨動態影像；磁振血管造影；頸動脈

並列摘要

To evaluate MR angiography (MRA) of the neck using the Time Resolved Imaging of Contrast Kinetics (TRICKS) technique and injection of half-dose gadobenate dimeglumine (Gd-BOPTA) if there is any significant impact on image quality. During the period from March 1, 2013 to October 31, 2013, 40 patients received MRA of the neck with half-dose contrast medium due to the patients glomerular filtration rate between 31 and 60, and they were therefore enrolled into our study. For the control, we randomly selected 40 patients who had MRA with normal-dose contrast medium during the same period. The two groups were compared with respect to vascular contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR). Two radiologists compared the image quality of the two groups in a double-blind setting. All 40 MRAs in the normal-dose group had good image quality. One in 40 MRAs in the half-dose group had suboptimal contrast enhancement, but still allowed image interpretation. Two observers, unaware of the circumstances, deemed no significant differences in image quality between the two groups of patients. The blood vessels of patients injected with normal-dose contrast had higher SNR and CNR than those injected with half-dose. TRICKS MRA of the neck with half-dose contrast did not significantly lower MRA image quality and interpretability. For patients with poor renal function, MRA performed with a reduced contrast dose may decrease the incidence of nephrogenic systemic fibrosis or nephrogenic fibrosing dermopathy.

並列關鍵字

Half Dose ； 3D TRICKS ； Magnetic Resonance Angiography ； Carotid Artery

國際替代計量

比較半劑量與正常劑量對比劑在頸部磁振血管造影之初步評估

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