| PART1:The Analysis of Factors Affecting Image Quality of Cervical Artery Angiography with64multi-slice CT by using SSCTA TechniqueObjective:By analyzing the factors affecting image quality of cevical angiography with64multi-slice CT using synchronous subtraction computed tomography angiography technique, so as to realize the optimization and quality control in the scanning process, and to improve the success rate of the examination and the image quality, and to increase the diagnostic accuracy, make the non-invasive SSCTA in cevical angiography and post-processing technology and perfect mature gradually.Methods:103cases were randomly gathered suspected with intracranial aneurysms performed SSCTA with64multi-slice CT, according to the head of fixed level into four groups, head of different fixed group subtraction image quality score and analysis of variance (ANOVA). In addition, in the103patients, weight range in53kg to110kg, of which65kg below,24cases,65kg to75kg of34cases,75kg to85kg of36cases, more than85kilograms of9cases. Different weight of the patients in the same injection rate and injection into the dose, the diameter of the cases, shows bilateral MCA average less than200Hu and neck sinus vein in the number of imaging.Results:(1) Ⅳ group and Ⅰ, Ⅱ,Ⅲ group (P<0.05), Ⅰ, Ⅱ, Ⅲ no significant differences between groups.(2) with the weight gain, line head blood vessels in the brain when CTA imaging intracranial arteries is below200in the CT Hu is the number of times with the weight increased; Sinus and neck in the number of venous imaging is reduced with the increase of the weight.Conclusions:(1) fixed degree and head head vascular synchronous subtraction imaging quality are positive correlated (2) weight and head vascular synchronous subtraction imaging quality a negative correlation (3) small doses of testing, intravenous your right elbow into the road and large diameter retained the rational use of needle can improve blood vessel CTA image quality of the head. Part2:The comparative study in two scanning mode of head and cervical arteries CTAPurpose:through the analysis of64-row MSCT head and cervical artery of the synchronous subtraction CTA examination of all kinds of factors affect the image quality, and emphatically compared the two groups of scanning mode for head and cervical artery CTA imaging quality of actor and bad, at the same time for the scanning process a quality control and optimization, so as to improve the success rate of the inspection, optimization and to strengthen the imaging quality diagnosis reliabilityMethods:the data of March2009to December2009in the2nd hospital shandong university clinical suspected carotid artery or vertebral artery stenosis and intracranial aneurysms cases,(human factors resulting in failure, patients with serious not and subtraction effect is poorer in the four points of the case is not within the scope of study,68patients were randomly.68patients were randomly divided into Ⅰ, Ⅱ two groups, and34cases. Ⅰ group scanning the positioning and scanning direction as to the top level arcade cranial direction scanning, small dose monitoring level test for neck3,4level; Ⅱ group scanning the positioning and scanning direction for cranial roof to aortic arch horizontal scan, small dose monitoring level test for brain artery level, the two groups were measured in bilateral internal carotid artery (neck3,4level), double side MCA, aortic arch and right within the subclavian veins CT value (Hu), and the statistical analysis on the measurement results.Results:I, between the two groups II bilateral intracranial MCA, internal carotid artery, the descending aorta intravascular CT value has no significant difference (p> 0.05), and two groups of the subclavian veins CT value significantly (p<0.05) Conclusion:according to the clinical needs, through practice of exploration, design the head and neck vascular scanning direction changes, namely the cranial roof to aortic arch horizontal scan, the clinical inspection effect is obvious, effective and good shows the head and neck blood vessels. Part3:The evaluation of partly synchronous subtraction technology in the head and Cervical Artery Angiography with64multi-slice CTObjective:to analyse the head and cervical artery angiography with64-row MSCT scanning in different scanning methods, the optimization of individual low dose scanning is presented, and the scanning process a quality control and optimization, improve the success rate of the inspection, optimize the image quality and lower absorbed dose patients, and realize the blood vessels of the head and neck CTA check standardization and standardized scanning.Methods:the cases from March2008to12months in the2nd hospital of shandong university with64-row MSCT suspected the carotid artery or vertebral artery stenosis cases and subarachnoid hemorrhage suspected cases of intracranial aneurysms (remove human factors resulting in failure and patients with severe not of cases), random case were160,160patients were randomly divided into eight groups, namely the fixed Kv and mA group and automatic mA scanning group, comparing different Kv and different mA between groups in the difference of the radiation dose parameters.Results:the comparison group head and neck completely subtraction and part of the subtraction of the CTA radiation dose, the radiation dose is statistically significant differences between (P<0.05). A1-1the radiation dose group highest, and no subtraction of B2-2groups of radiation dose minimum. And through the comparison group, head and neck completely subtraction of subtraction and no subtraction of group, some subtraction group in the radiation dose reductions effect significantly, A1, A2-2groups-1group,2group, A2-B1-1, B1-2groups of effective absorbance dosage (ED) were reduced43%,44%,37%,36%,44%,45%, entirely subtraction of B2-2groups of radiation dose minimum, only for complete subtraction A1-1group of8%, radiation dose92%lower.Conclusion:the automatic ma technology (ATCM) and synchronous part subtraction technology joint inspection of the head and neck vascular CTA, can get not only the high success rate and diagnosis accuracy of inspection, also can be reduced to a great extent patients receied radiation dose... |
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