| Objectives To research the effects of image quality about renal artery and its branches CT angiography(CTA) with different contrast medium concentration, and different injection rate and different scan delay time. And the application value in CT renal artery angiography(CTA) in with Different post-processing technology combination.Methods 1.Selected 441 cases patients in our hospital underwent renal artery CTA examination: in which 252 cases were randomly divided into(I ~ IV) four big groups(there were 63 cases in each group) according to the contrast medium concentration and injection rate of drug. Group I: the injection rate was 5.0ml/s, and the contrast medium concentration was 370 mg I/ml(iodine amine). Group II: the injection rate was 4.0 ml/s,and the contrast medium concentration magi were 370 mg I/ml(iodine amine). Group III:the injection rate was 5.0 ml/s, and the contrast medium concentration was 300 mg I/ml(iohexol 300). Group IV: the injection rate was 4.0 ml/s, and the contrast medium concentration was 300 mg I/ml(iohexol 300). Then transmitted the data and took image reconstruction to EBW 4.0.2.145 workstation. And the other 189 cases were randomly divided into(A, B, C) three big group(there were 63 cases in each group) according to the scan delay time, In group A: after regular scans late 20 s started the scanning; In Group B: after regular scans late 25 s started the scanning; In Group C: after regular scans late 30 s started the scanning. Then transmitted the data to EBW4.0.2.145 work station and take image reconstruction. 2. About the Post-processing technology: selected 63 cases as the research object in the contrast medium concentration and injection drug rate group(group I: the injection rate were 5.0 ml/s, the contrast medium concentration were magi 370 mg I/ml(iodine amine)), then reconstructed the cross sectional image into a thin layer of 0.625 mm images and transmitted them into EBW4.52 workstation, all cases were taken post-processing technology and divided into three groups: Group(1): there were MPR+MIP. Group(2): there were MIP+VR. Group(3): there were CPR+MIP. We observed the situation of the three groups in renal artery and their branches. All data used SPSS 17.0 statistical software for statistical.Results When the contrast medium concentration were 370 mg I/ml: the showing levels of renal artery and branches in which group the contrast medium injection rate were 5.0ml/s were significantly higher than the group with drug flow rate were 4.0 ml/s. The CTA image quality score were respectively(4.690 ± 0.177) and(4.634 ± 0.158) points, there were significant differences between the two groups(P < 0.01). When the contrast medium concentration were 300 mg I/ml: the showing levels of renal artery and branches in which group the contrast medium injection rate were 5.0 ml/s were significantly higher than the group with drug flow rate were 4.0 ml/s, the CTA image quality score were respectively(4.531 ± 0.189) and(3.373 ± 0.162) points, there were significant differences between the two groups(P < 0.01). When the contrast medium injection rate were 5.0ml/s: the showing levels of renal artery and branches in which group the injection of contrast medium concentration were 370 mg I/ml(iodine amine) were significantly higher than the group with contrast medium concentration were 300 mg I/ml(iohexol 300), the CTA image quality score were respectively(4.690 ± 0.177) and(4.531 ± 0.189) points,there were significant differences between the two groups(P < 0.01). When the contrastmedium injection rate were 4.0 ml/s: the showing levels of renal artery and branches in which group the injection of contrast medium concentration were 370 mg I/ml(iodine amine) were significantly higher than the group with contrast medium concentration were300 mg I/ml(iohexol 300), the CTA image quality score were respectively(4.634 ± 0.158)and(3.373 ± 0.162) points, there were significant differences between the two groups(P< 0.01). when the scanning delay time under different conditions, in group A(about scanning after regular scans late 20s) the levels showed of renal artery and branches were significantly higher than group B(conventional scanning delay after 25 s scan) and group C(conventional scanning delay after 30 s scan)(P < 0.05). The CTA image quality score were respectively in group A(20s):(4.740 ± 0.123) and in group B(25s):(4.065 ± 0.119)points, in group C(30s):(4.072 ± 0.076) points, group A(20s) were better than that of group B(25s) and C group(30s)(P < 0.05). Post-processing techniques:(1) In(MPR +MIP) group: the main renal artery and the I and class II renal artery branches were showed clearly, the rate was 100%, the level III branch was 95.2%, the level IV branch was 89.6%, the level branch was 75.3%, the level VI branch was 38.0%.(2) In(MIP+VR)group: the main renal artery and the I and class II renal artery branches were showed clearly, the display rate was 100%, the level III branch was 93.6%, the level IV branch was 87.3%, the level V branch was 73.8%, the level VI branch was 35.7%.(3)In(MIP +CPR) group : main renal artery and the I and class II renal artery branches were showed clearly, the display rate was 100%, the level III branch was 92.0%, the level IV branch was 85.7%, the level V branch was 71.4%, the level VI branch was 31.7%. Renal artery and branches vascular enhancement could meet the needs of the clinical diagnosis. The Three groups of main renal artery and the I and class II renal artery branch display effect were same, MPR and MIP group of renal artery branch of grade III, IV, V, VI display effect were better than that of MIP + VR and MIP + CPR group.Conclusions Different contrast medium injection rate, concentration and scan delay time have influence on the renal artery CTA image quality. The higher concentration of contrast medium 370 mg I/ml(iodine amine) and faster drug injection rate(5ml/s)combined with optimal scan delay time(20s) can obtain high quality of the renal artery and branches at all levels CTA images. MPR + MIP composite processing technology can make the renal artery and its branches anatomical structures such as to get a good showing with 256 application layer spiral CT. |
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