身体成分对胸部CT造影剂增强的影响:一项随机对照试验。

BJR open Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI:10.1259/bjro.20230054
Mette Karen Henning, Trond Mogens Aaløkken, Anne Catrine Martinsen, Safora Johansen
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引用次数: 0

摘要

目的:比较胸部CT中固定体积造影剂(CM)方案与综合总体重(TBW)和身体成分定制方案。方法和材料:常规胸部CT增强扫描的患者前瞻性地分为正常、肌肉发达或超重。患者被随机分为两组;第1组收到一个固定的CM协议。第2组根据身体成分定制方案接受CM体积。对方案和身体成分之间的图像质量进行了客观比较。使用t检验和Pearson’s r分析各组之间的差异和相关性。结果:共有179名患者被纳入:第1组87名(平均年龄51±17岁);第2组92例(平均年龄52±17岁)。与第2组相比,第1组的肌肉血管衰减较低(平均346 Hounsfield单位(HU)vs 396 HU;p=0.004)和超重类别(平均342 HU vs 367 HU;p=0.012),而正常类别患者的衰减增加(385 vs 367;p=0.061)。在第1组中,肌肉衰减与TBW(r=-0.49,p=0.009)和超重患者的腰围(r=-0.50,p=0.005)之间的相关性最强。在第2组中,对于相同的体型参数,没有发现显著的相关性。在第1组中,13%的超重患者低于250HU(p=0.053)。结论:与固定体积方案相比,TBW和身体成分定制的CM方案在胸部CT中产生了更均匀的增强和更少的异常值。知识进步:据我们所知,这是第一项研究各种身体成分对胸部CT造影剂增强的影响的研究。
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The impact of body compositions on contrast medium enhancement in chest CT: a randomised controlled trial.

Objective: To compare a fixed-volume contrast medium (CM) protocol with a combined total body weight (TBW) and body composition-tailored protocol in chest CT.

Methods and materials: Patients referred for routine contrast enhanced chest CT were prospectively categorised as normal, muscular or overweight. Patients were accordingly randomised into two groups; Group 1 received a fixed CM protocol. Group 2 received CM volume according to a body composition-tailored protocol. Objective image quality comparisons between protocols and body compositions were performed. Differences between groups and correlation were analysed using t-test and Pearson's r.

Results: A total of 179 patients were included: 87 in Group 1 (mean age, 51 ± 17 years); and 92 in Group 2 (mean age, 52 ± 17 years). Compared to Group 2, Group 1 showed lower vascular attenuation in muscular (mean 346 Hounsfield unit (HU) vs 396 HU; p = 0.004) and overweight categories (mean 342 HU vs 367 HU; p = 0.12), while normal category patients showed increased attenuation (385 vs 367; p = 0.61). In Group 1, strongest correlation was found between attenuation and TBW in muscular (r = -.49, p = 0.009) and waist circumference in overweight patients (r = -.50, p = 0.005). In Group 2, no significant correlations were found for the same body size parameters. In Group 1, 13% of the overweight patients was below 250 HU (p = 0.053).

Conclusion: A combined TBW and body composition-tailored CM protocol in chest CT resulted in more homogenous enhancement and fewer outliers compared to a fixed-volume protocol.

Advances in knowledge: This is, to our knowledge, the first study to investigate the impact of various body compositions on contrast medium enhancement in chest CT.

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