在急性出血中CT血管造影:是否需要非增强型扫描?
Johannes Bremm1, Jörn Henze1, Thomas Dratsch1
1University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Germany.
无对比计算断层扫描 (CT) 扫描通常不需要检测出血,可能会减少辐射暴露. 然而,它可能有助于排除胃肠道出血病例的假阳性.
科学领域:
- 放射学和成像学 放射学和成像学
- 医学诊断 医学诊断 医学诊断
- 干预性放射学 干预性放射学
背景情况:
- 计算机断层扫描血管造影 (CTA) 对于检测和定位出血至关重要.
- 通常使用的是三相CTA协议,包括非对比,动脉和门静脉阶段.
- 在CTA中非对比阶段对于出血检测的必要性需要进一步调查.
研究的目的:
- 评估非对比CT扫描在出血检测中的附加值.
- 提供支持或反驳在出血方案中常规使用非对比CT的证据.
- 评估非对比CT对整体辐射暴露的影响.
主要方法:
- 为怀疑出血而接受三相CT血管造影的患者 (2014-2020年) 的回顾性分析.
- 两名经验丰富的观察员重新评估了CT扫描,以确定在没有非对比阶段的情况下是否可以检测出出血.
- 记录了辐射剂量数据,包括剂量长度产品 (DLP).
主要成果:
- 包括75名患者;43%的人有胃肠道 (GI) 出血.
- 无对比CT仅在5.2%的病例中被认为是有帮助的,主要是对于肠道出血.
- 非对比扫描显著增加了辐射暴露 (DLP平均值为927.9mGy*cm).
结论:
- 在CTA中检测出血时,非对比CT在很大程度上是不必要的.
- 省略非对比CT扫描可以导致显著的辐射剂量减少.
- 在特定情况下,非对比CT可能是有益的,例如排除疑似肠道出血的错误阳性.
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