64层CT冠状动脉成像的前瞻性与回顾性心电门控比较  

Diagnostic performance of prospective versus retrospective electrocardiogram-gated 64-slice computed tomography coronary angiography

作　　者：袁旭春[1] 邱翔[1] 王贤主[1] 廖文凌[1] 陈琴[1] 邓慧仪[1] 

机构地区：[1]深圳市孙逸仙心血管医院放射科,518020

出　　处：《中华心血管病杂志》2008年第11期985-988,共4页Chinese Journal of Cardiology

摘　　要：目的比较前瞻性心电门控和回顾性心电门控64层CT冠状动脉成像的辐射剂量和成像质量，探讨低剂量前瞻性心电门控CT冠状动脉成像的可行性。方法两组心率≤65次／min各100例患者分别进行前瞻性和回顾性心电门控扫描，并采用多平面重组（MPR）、最大密度投影（MIP）、曲面重组（CPR）及容积再现（VR）多种重组技术显示冠状动脉，图像质量根据运动伪影影响分为优、良、差，使用剂量长度计算各自的有效辐射剂量，并进行统计学分析。结果前瞻性组平均辐射剂量为（2．81±0．48）mSv明显低于回顾性组的（10．16±1．09）mSv（P〈0．01）；前瞻性组诊断性冠状动脉节段和非诊断性冠状动脉节段为95．2％（1165／1224）和4．8％（59／1224），与回顾性组的94．1％（1186／1261）和5．9％（75／1261）比较，差异无统计学意义。结论对于心率稳定在65次／min以下的患者，前瞻性心电门控64层CT冠状动脉成像，能以较低的辐射剂量达到回顾性心电门控诊断质量的影像，是切实可行的方法。Objective To compare the diagnostic performance of prospective electrocardiogram （ECG）-triggered computed tomography coronary angiography （CTCA） versus retrospective ECG-gated CTCA. Methods Patients with suspected coronary artery disease divided into two groups which underwent 64-slice CTCA with prospective ECG-triggered or retrospective ECG-gated scanning （n = 100 each, HR ≤65 bpm）. Multi-planar reconstruction （MPR）, curved-planar reconstruction （CPR）, maximum intensity projection （MIP） and volume rendering （VR） were made to demonstrate the coronary arteries. The image quality was defined as excellent, good and poor by motion and stair-step artifacts. Individual radiation exposure dose was estimated from the dose-length product. Results The mean effective radiation dose of prospective ECG-triggered CTCA [ （ 2. 81 ± 0.48 ） mSv ] was significantly lower than that of retrospective ECG-gated CTCA[ （ 10. 16 ±1.09） mSv, P 〈0. 011. Segments of diagnostic image quality （95.2%, 1165/ 1224）and non-diagnostic coronary segments （4. 8%, 59/1224）in prospective ECG-triggered group were similar as those of retrospective ECG-gated group （94. 1%, 1186/1261 and 5. 9%, 75/1261, all P 〉 0. 05 ）. Conclusion Though the radiation exposure dose required is significantly lower, the diagnostic performance of prospective ECG-triggered 64 slice CTCA is comparable with that of retrospective ECG-gated 64 slice CTCA on patients with stable heart rates up to 65 bpm.

关 键 词：体层摄影术 X线计算机 冠状血管造影术 前瞻性心电门控 

分 类 号：R686[医药卫生—骨科学]