64排CT冠状动脉造影:心率及心率变化对图像质量的影响  

64-dectector row CT coronary angiography:effect of heart rate and heart rate variability on image quality

作　　者：吕国士[1] 王炳胜[1] 王德韧[1] 左宏[1] 云浩[1] 

机构地区：[1]解放军251医院影像中心,河北张家口075000

出　　处：《医学影像学杂志》2007年第12期1277-1281,共5页Journal of Medical Imaging

摘　　要：目的:探讨患者心率、心率变化对64排CT冠脉图像质量的影响。方法:前瞻性分析86例64排CT冠脉造影的患者,在20%～80%R-R间期、间隔5%重组原始数据,分别选择冠状动脉各主干最佳重建时相,评估冠脉各节段的图像质量。计算患者平均心率和扫描过程中心率变化。采用Person相关检验比较平均心率、心率变化与图像质量的相关性。结果:82例患者的平均心率为65.3±12.9,心率变化为3.2±2.1,52(63.4%)例服用β受体阻滞剂患者的平均心率为64.9±13.8,心率变化为2.6±1.4;30(36.6%)例未服用β受体阻滞剂患者的平均心率为65.8±12.3,心率变化为4.6±2.1,二者相比有显著性差异(P<0.05)。82例患者共有1198冠脉节段被评估,1167(97.4%)节段可用于诊断。患者平均心率与冠脉总体及RCA、LM和LAD、LCX图像质量无明显相关性(r=0.22,0.15,0.16,0.24,P=0.05)。扫描期间心率变化与冠脉总体图像质量有显著相关性(r=0.75,P=0.001),与RCA、LCX、LAD和LM图像质量均有相关性(P<0.001),相关程度依次为RCA(r=0.77)、LCX(r=0.69)、LAD和LM(r=0.68)。结论:在心率较快的条件下,64排CT冠脉图像质量明显提高,扫描过程中心率变化可显著影响冠脉图像质量,服用β受体阻滞剂可明显降低心率变化幅度,从而提高冠脉图像质量。Objective：To evaluate the effect of average heart rate and heart rate variability on image quality at 64-dectector row CT coronary angiography.Methods： Prospectively ECG-gated 64-dectector row CT coronary angiography were performed in 86 cases. Data sets were reconstructed in 5% steps from 20% - 80% of R-R interval. Selected the optimal reconstruction window, each of coronary segment were rated with regard to image quality. Pearson correlation analysis was performed to compare image quality in each patient with average heart rate and heart rate variability.Results：Average heart rate were 65.3±12.9,64.9 ±13.8, 65.8 ±12.3 beats per minute in 82 patients, in 52（63.4% ） receivingβ-blockers, in 30（36.6% ） not receiving β-blockers, with variability of 3.2 ±2.1, 2.6 ±1.4, 4.6 ± 2.1 beats per minute, respectively. There was significant difference between patients not and receiving β-blockers for heart rate variability. Diagnostic image quality was attained in 1167（97.4%） of 1198 segments at the best reconstruction interval. There was no correlation between mean heart rate and image quality for overall and for right coronary, left main, left descending and left circumflex artery. Heart rate variability was correlated with image quality overall and for each coronary artery. These correlations were higher for the RCA and along with the LCX, the LM and LAD. Conclusion：64-dectector row CT coronary angiography can provides diagnostic image quality with higher heart rates. Heart rate variability during scaraning can obviously impact the image quality of coronary angiography. Receiving IS-blockers can reduced heart rate variability and improved the image quality.

关 键 词：冠状血管造影术 体层摄影术 X线计算机 图像处理 

分 类 号：R541[医药卫生—心血管疾病] R814.42[医药卫生—内科学]