不同心率水平下双源CT冠状动脉成像质量研究  

Image Quality of Dual-Source CT Coronary Angiography at Different Heart Rate Level

作　　者：孙志远[1] 卢光明[1] 黄伟[1] 王俊鹏[1] 陈鹏[1] 周长圣[1] 张龙江[1] 李林[1] 蔡军[1] 张玥玥[1] 

机构地区：[1]南京军区南京总医院医学影像科,南京210002

出　　处：《放射学实践》2008年第10期1089-1095,共7页Radiologic Practice

摘　　要：目的：研究不同心率状态下双源CT的冠状动脉成像质量情况及收缩期和舒张期成像质量的差异。方法：345例受试者，男248例，女97例，年龄24～86岁，心率49～133次／分，平均心率74．2±14．4次／分（均未给予药物控制心率），行双源CT冠状动脉CTA扫描，在后处理工作站进行三维重组后，由两名有经验的放射医师对所有受检对象的冠状动脉成像质量进行分段评分（1分～5分）。按受检时心率分为5组，分别统计各组冠状动脉各段的成像质量评分，收缩期和舒张期最佳时相的成像质量评分，以及最佳时相在R—R间期的分布情况。结果：成像成功率为99．9％（3392／3395）。图像质量评分总均值为（4．76±0．57），评分均值与心率呈负相关（r=-0．973，P=0．005）。当心率增高时，收缩期的成像质量和舒张期的成像质量均有下降的趋势，但收缩期下降幅度与舒张期比较明显较缓。当心率〈80次／分时，最佳时相多数在舒张期得到．占79．6％（183／230），特别集中于R—R间期的70％左右，占68．3％（157／230）．有88．7％（306／345）的受检对象在收缩期和舒张期两期都能得到优良（4分以上）的图像；当心率≥80次／分时，最佳时相多数在收缩期得到，占83．5％（96／115），仅有10．4％（12／345）的受检对象在收缩期和舒张期两期都能得到优良的图像。结论：在排除了心律不齐影响因素的情况下，双源CT在患者处于自然心率状态下其冠状动脉成像成功率接近100％；但心率对冠状动脉成像质量仍有一定影响；当心率〈80次／分时大多数可以在收缩期和舒张期双期成像，而心率≥80次／分时一般只能在收缩期成像。Objective：To study the image quality of dual source CT （DSCT） coronary angiography,and to discuss the difference of image quality in systole and in diastole. Methods： 345 patients, including 248 men and 97 women, whose age varied from 24 to 86 years and heart rate from 49 to 133bpm （never receiving medicine to control heart rate）, underwent DSCT coronary artery angiography exam. After being reconstructed in post-processing workstation, the coronary images （3395 segments） were evaluated by two experienced radiologists （scores from 1 to 5）. According to the heart rate in the exam,the patients were divided into 5 groups. The mean scores, the scores in systole and in diastole,and best reconstructionphase of each group were counted. Results： 99.9 % （3392/3395） segments reached diagnostic standards. The mean score of image for all patients was（4.76±0.57）. A significant negative correlation was observed between heart rate and image quality（r=-0. 973, P=0. 005）. The image quality both in systole and in diastole decreased with the heart rate increasing, but the gradient in systole was lower than that in diastole. When the heart rate was ≤80bpm, best reconstruction phase was found in diastole （50%-90%） in 183 （79.60/oo） patients,and,there were 306 （88.7%） patients whose images could be found fine both in systole and in diastole. When heart rate 〉80bpm, best reconstruction phase was found in systole in 96 pa tients （83.5%）,especially centered on R-R 400/00 or so,which had 67.0% （77/115） ,and, there were only 12 （10.4%） patients whose images could be found fine both in systole and in diastole. Conclusion：Under the circumstances of excluding ar rhythmia, the imaging achievement ratio of DSCT coronary angiography almost reached 100 % when the patient＇s heart rate was not controlled,but the quality of image was still influenced by heart rate in a certain degree. When patien（s heart rate ≤80bpm, fine images could he found both in systole and in diastole in mo

关 键 词：体层摄影术 X线计算机 心脏 冠状动脉循环 

分 类 号：R816.2[医药卫生—放射医学]