双源CT前瞻性心电门控扫描在急性胸痛诊断中的临床应用  

Application of prospective dual-source CT in patients with acute chest pain DUAN

作　　者：段艳华[1] 王莉[2] 王锡明[1] 乌大尉[1] 程召平[1] 李剑[1] 晁宝婷[1] 武乐斌[1] 柳澄[1] 徐卓东[1] 

机构地区：[1]山东大学医学院山东省心脑血管疾病诊治重点实验室山东省医学影像学研究所,济南250021 [2]山东省立医院PET—CT诊疗中心

出　　处：《中华放射学杂志》2011年第1期32-36,共5页Chinese Journal of Radiology

基　　金：山东省科学技术发展计划资助项目（2008GG30002049）

摘　　要：目的探讨双源CT（DSCT）前瞻性心电门控扫描在急性胸痛诊断中的临床应用，并比较前瞻性心电门控与回顾性心电门控2种扫描技术的图像质量和辐射剂量。方法连续搜集30例[A组，平均心率／〉85次／min（bpm）]临床症状表现为急性胸痛并行DSCT前瞻性心电门控心胸联合血管成像的患者，连续搜集30例（B组，所有患者平均心率≥85bpm）表现为急性胸痛行DSCT回顾性心电门控扫描的患者。对2组患者的冠状动脉、肺动脉及主动脉分别进行靶重组，评价2组图像质量，并对疾病进行诊断；应用）（2检验和两独立样本t检验比较2组患者的图像质量和有效剂量。结果A、B组可评价冠状动脉节段比例分别为98．44％（379／385）和98．48％（390／396），差异无统计学意义（X^2=0．002，P=0．961）；A、B组间图像噪声[分别为（16．23±5．75）、（16．31±3．32）HU]、信噪比（分别为26．85±9．94、24．78±9．91）及对比度噪声比（分别为20．99±9．31、18．65±8．72）差异均无统计学意义（t值分别为0．069、0．908、1．224，P值均〉0．05）；A、B2组有效剂量分别为（8．37±2．69）和（20．05±5．52）mSv，差异有统计学意义（t=9．401，P=0．000）。结论DSCT前瞻性心电门控心胸联合血管成像可以获得与回顾性心电门控扫描相似的图像质量，且辐射剂量降低。Objective To evaluate the application of prospective ECG-gated dual source CT （DSCT） in patients with acute chest pain, and compare it＇s image quality and radiation dose with those of retrospective ECG-gated spiral scan. Methods Thirty consecutive patients （Group A, average HR ≥ 85 bpm） with acute chest pain were scanned with prospective ECG-gated scan and another 30 consecutive patients （Group B, average HR≥85 bpm）were analyzed by retrospective ECG-gated scan. Tube voltage and tube current were adapted by the BMI of patients. MPR, MIP, CPR and VR were used to display pulmonary arteries （PA）, thoracic aorta and coronary arteries （CA）. Image quality as well as radiation dose were assessed in 2 groups. Qualitative image quality was compared with chi-square test between the two groups, while quantitative image quality [ the image noise （IN） , signal-to-noise ratio （SNR） and contrast-to-noise ratio（CNR） ] and radiation dose were evaluated with X2 test and Student＇s t test. Results The proportion of valid coronary segments for diagnosis were 379/385 （98.44%） and 390/396 （98.48%） respectively in Group A and Group B with no significant difference（ X2 = 0. 002, P = 0. 961 ）. The IN [ （16. 23± 5.75 ）vs （16. 31 ±3.32） HU ] ,SNR （26. 85 ±9. 94 vs 24. 78 ±9.91） and CNR （20, 99 ±9. 31 vs 18.65 ±8. 72） showed no significant differences between 2 groups （t = 0. 069,0. 908 and 1. 224, P 〉 0. 05, respectively）. The ED was on average （ 8. 37 ± 2. 69 ） mSv in Group A, whereas on average （ 20. 05± 5.52 ） mSv in Group B. There was a statistical difference between 2 groups （t =9.401,P =0.000）. Conclusion Low dose prospective ECG-gated DSCT angiography can show similar image quality as retrospective ECG-gated spiral scan with radiation dose.

关 键 词：体层摄影术 X线计算机 胸痛 辐射剂量 

分 类 号：R816.2[医药卫生—放射医学]