640层CT冠状动脉造影中的心率变化及辐射剂量分析  

The Analysis of Variation of Heart Rate and Radiation Dose during Coronary Angiography with 640-slice CT

作　　者：王振[1] 袁建华[1] 丁忠祥[1] 狄幸波[1] 徐健[1] 张玉江[1] 

机构地区：[1]浙江省人民医院放射科,浙江杭州310014

出　　处：《实用放射学杂志》2011年第6期929-932,共4页Journal of Practical Radiology

摘　　要：目的探讨不同心率条件患者行640层CT冠状动脉造影前后的心率变化和辐射剂量的关系。方法根据采集心动周期数将100例行640层CT冠状动脉造影的连续病例分为3组，分别为A组31例（心率〈65次／min），B组53例（心率65～79次／min），C组16例（心率〉80次／min）。记录扫描前和扫描中的心率及辐射剂量指标进行统计分析。结果扫描中实时心率明显低于扫描前平均心率（P〈0．001），平均下降约4．54次／min。A组扫描中实时心率比扫描前平均心率下降约2．21次／min（P=0．053），无统计学差异（P〉0．05），B组和C组的扫描中实时心率比扫描前平均心率分别下降约4．59次／min和8．89次／min，均有明显的统计学差异（P〈0．005）。A组、B组和C组组间的辐射剂量均有明显的统计学差异（P〈0．001）。C组、B组和A组的辐射剂量依次由高到低分别为（11．1±3．9）mSv、（8．5±3．2）mSv、（2．4±0．9）mSv。结论控制心率仍是一个有效减少640层CT冠状动脉造影辐射剂量的手段，扫描过程中心率会有所下降，这可能有助于提高采集方案的心率适用范围，增加受益人群比例。Objective To analyse the relationship between the variation of heart rate （HR） and radiation dose during coronary angiography with 640-slice CT （CTA）. Methods One hundred patients underwent CTA,and they were divided into three groups： group A （31 cases , HR 〈 65 beats/min） ,group B （53 cases,HR=65-79 beats/min）, Group C （16 cases, HR 〉 80 beats/min）. The radiation dose and mean heart rate of pre-scan and during scan were recorded and analysed statistically with SPSS 13.0 software. Results Real heart rate during scan acquisition was significantly lower than mean heart rate of pre-scan （reducing averagely 4.54 beats/rain, P〈0. 001 ）. There was no statistically different between real heart rate during scan acquisition and pre-scan in group A. Real heart rate during scan acquisition was significantly lower than mean heart rate of pre-scan in group B and group C （reduce 4.59 and 8.89 beats/min respectively, P〈0.01）. The radiation doses in group A,group B and group C were （2.4±0.9）, （8.5±3.2） and（11.1±3.9）mSv,respectively,there was significantly different between them. Conclusion Heart rate control is an important role to reduce the radiation dose during CTA. Real heart rates during CT scan acquisition may decrease,which is helpful to improve the applied extent of variation of heart rate during CTA.

关 键 词：心脏 冠状动脉造影 体层摄影术 X线计算机 辐射剂量 

分 类 号：R322.11[医药卫生—人体解剖和组织胚胎学] R814.43[医药卫生—基础医学]