64排螺旋CT胸痛三联排查低剂量研究  

Triple Examination of Acute Chest Pain using 64-slice Spiral CT with Low Radiation Dose

作　　者：王泽锋[1] 刘挨师[1] 赵磊[1] 蒲俊智[2] 

机构地区：[1]内蒙古医学院附属医院CT室,内蒙古呼和浩特010050 [2]呼和浩特市第一医院CT室

出　　处：《实用放射学杂志》2011年第3期437-440,共4页Journal of Practical Radiology

基　　金：内蒙古财政厅科研项目（NJZY07091）;内蒙古高等学校科学研究项目（NC20080018）.

摘　　要：目的 探讨64排螺旋CT低辐射剂量胸痛三联排查的临床价值.方法 从胸痛三联排查的患者中连续选取95例,且心率≤65次/min,心率波动范围≤5次/min.95例随机分为A、B 2组,A组48例采用前门控轴扫,B组47例采用后门控螺旋扫描.所有病例体质量指数（BMI）≥24 kg/m2,管电压选择120 kV BMI＜24 kg/m2,管电压选择100 kV 根据BMI设置管电流（230～740 mA）.以冠状动脉图像质量评分作为质控指标.采用两独立样本t检验对2组的射线剂量、图像质量评分、BMI、扫描时患者心率波动范围进行统计学分析.结果 A组平均受线剂量为（7.96±2.85） mSv,图像质量评分平均为（4.76±0.55）分 B组平均受线剂量为（23.80±8.90） mSv,图像质量评分平均为（4.81±0.46）分.2组之间图像质量评分无显著性差异（t=1.93,P＞0.05）.A组受线剂量与B组相比有统计学差异（t=11.64,P＜0.05）,平均受线剂量减少约66.6%.结论 应用64排螺旋CT采用前门控轴扫技术行胸痛三联排查,图像质量可靠,患者受线量少,值得向临床推广.Objective To evaluate the feasibility of low radiation dose triple examination in acute chest pain using 64-slice spiral CT. Methods 95 consecutive patients underwent triple examination（heart rate≤65 beats per minute,range≤5 beats per minute）. They were randomly divided into two groups, group A （48 cases）and B（47 cases）. Prospective ECG-triggered axial scan protocol and retrospective ECG-gated spiral scan protocol were used respectively in group A and B. The other parameters included 120 kV in the patients with body mass index（BMI）≥24 kg/m2 , 100 kV in the ones with BMI〈24 kg/m2 , and the tube current was set according to BMI. The radiation dose and image quality were evaluated with statistical t-test. Results The radiation doses in group A and B were （7.96±2.85） mSv and （23.80±8.90） mSv, respectively. There was no significant difference in image quality between group A and B（t=1. 93,P〉0.05 ） . Radiation dose in group A was decreased by 66.6% compared with that of group B（ t=11.64 , P〈0.05）. Conclusion Triple examination in acute chest pain using prospective ECG-triggered axial scan protocol with 64-slice spiral CT can significantly reduce radiation exposure while maintaining image quality.

关 键 词：胸部 胸痛 三联排查 辐射剂量 体层摄影术 X线计算机 

分 类 号：R323.2[医药卫生—人体解剖和组织胚胎学] R56[医药卫生—基础医学]