目的 探讨对比剂不同注射方 案对头颈部CT血管造影术(CTA)图像质 量的影响。方法 选择我院2014年1月至 2017年1月行头颈部CTA检查患者96例， 按照随机数字表法分为A组(n=48）和B组 (n=48)，两组对比剂均为370mgI/mL碘帕 醇，对比剂总量为60mL，右肘前静脉注 入，注射速率为5mL，追加生理盐水总量 为70mL，A组生理盐水注入速率为5mL/ s，B组生理盐水注入速率4mL/s，比较 两组客观图像质量[平均CT值、信噪比 (SNR)及对比噪声比(CNR)]、主观图像质 量[血管和周围结构对比度、管腔边缘锐 利度、噪声和图像清晰度]、辐射剂量 [CT剂量指数(CTDI)、CT剂量长度乘积 (DLP)、有效辐射剂量(ED)]。结果 A组主 动脉弓和颈动脉分叉区动脉血管平均CT 值、SNR与B组均无显著差异(P>0.05)， CNR显著高于B组(P<0.05)；A组血管和周 围结构对比度、管腔边缘锐利度和图像 清晰度均显著高于B组(P<0.05)，噪声 与B组无显著差异(P>0.05)；A组CTDI、 DLP、ED与B组均无显著差异(P>0.05)。 结论 追加生理盐水注入速率越快，头颈 部CTA图像质量越高，以和对比剂流速相 同的盐水冲洗速率为佳。

Objective To explore the effects of different injection schemes of contrast media on the CT angiography (CTA) image quality of head and neck. Methods 96 cases of patients with head and neck CTA examinations from January 2014 and January 2017 in our hospital were selected and divided into the group A (n=48) and the group B (n=48) according to the random number table method. The contrast media of the two groups were 370mgI/mL iopamidol with the total amount of 60mL, and the patients were given the right anterior elbow vein injection with the injection rate of 5mL and then they were additionally given the normal saline with the total amount of 70mL. And the group A was given the saline injection rate of 5mL/s, and the group B was given the saline injection rate of 4mL/s. The objective image quality [average CT value, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)], the subjective image quality [contrast degree of blood vessels and peripheral structures, lumen edge sharpness degree, noise and image definition], radiance dose [CT dose index (CTDI), CT dose length product (DLP), effective radiation dose (ED)] were compared between the two groups. Results There was no significant difference in the average CT value and SNR in the aortic arch and carotid bifurcation between the group A and the group B (P>0.05), and the CNR was significantly higher than that in the group B (P<0.05). The contrast degree of vessel and surrounding structures, the sharpness degree of lumen edge, noise and image definition in the group A were significantly higher than those in the group B (P<0.05), and there was no significant difference in the noise compared with that in the group B (P>0.05). There was no significant difference in the CTDI, DLP and ED between the group A and the group B (P>0.05). Conclusion Thefaster the additional saline injection rate is, the higher CTA image quality of head and neck is. And the same contrast media flow rate and the saline flushing rate can have good effects.