256层螺旋CT低剂量心脑血管联合成像初步研究  

Low dose 256-slice spiral CT of coronary combined with carotid and cerebrovascular angiography

作　　者：张晓东[1] 唐秉航[1] 李芳云[1] 李良才[1] 黄晖[1] 何亚奇[1] 吴任国[1] 黄德成[1] 梁健雄[1] 赖紫霞[1] 

机构地区：[1]中山大学附属中山医院广东省中山市人民医院CT室,528403

出　　处：《中华放射学杂志》2011年第11期1008-1012,共5页Chinese Journal of Radiology

摘　　要：目的初步探讨256层螺旋CT前瞻性心电门控心脑血管联合成像的图像质量与辐射剂量。方法回顾性分析57例患者CTA资料。组1：心脑血管联合CTA（n=17），应用大范围前瞻性心电门控行冠状动脉、颈动脉及脑血管一站式扫描；组2：冠状动脉CTA（n=20）：前瞻性心电门控行常规冠状动脉成像；组3：常规颈脑血管CTA（n=20）。分别测量各组升主动脉根部、双侧颈总动脉起始部、椎动脉起始部、颈内动脉（蝶鞍层面）图像CT值与图像噪声；采用4分法评估冠状动脉图像质量，3分法评估颈脑血管图像质量；分别计算各组的辐射剂量。采用t检验比较组间的图像CT值与噪声；采用Mann—WhitneyU检验比较组1与组2冠状动脉图像质量及组1与组3颈脑血管图像质量。结果组1与组2升主动脉根部CT值[分别为（427±50）、（426±86）HU]、噪声[分别为（30±9）、（31±9）HU]差异均无统计学意义（t值分别为0．058、-0．325，P值均〉0．05）；冠状动脉图像质量评分组1与组2均满足诊断需要冠状动脉节段，优良分别达到98．1％（202／206）、99．6％（244／245）；两组间图像质量比较差异无统计学意义（Z=-0．572，P〉0．05）。组1与组3颈总动脉起始部CT值[分别为（474±70）、（348±81）HU]、椎动脉起始部CT值[分别为（447±83）、（328±66）HU]差异均有统计学意义（t值分别为5．043、4．869，P值均〈0．05）；颈内动脉（蝶鞍层面）CT值[分别为（370±92）、（367±97）HU]两组比较差异无统计学意义（t=0．111，P〉0．05）。组1颈脑血管图像质量评分1分1例，2分14例，3分2例；组3颈脑血管图像质量评分2分7例，3分13例；两组图像质量评分比较差异有统计学意义（Z=-3．306，P〈0．05）。组1、组2、组3有效辐射剂量分别为（7．0±0．8）、（3．1±0．4）、（5．0±0．3）mSv。结论256层螺旋CT大范围前瞻性心电门控�Objective To investigate image quality and radiation dose of prospective ECG-gated coronary combined with carotid and cerebrovaseular angiography and compare it with common coronary CTA and carotid-cerebrovascular CTA at a 256-slicc spiral CT. Methods Fifty-seven patients were included in the study. The data was analyzed retrospectively and divided into 3 groups. Group 1 underwent coronary combined with carotid CTA （n = 17 ） , which included a wide range of prospective ECG-gated coronary, carotid and cerebral vascular one-stop angiography. Group 2 underwent coronary CTA （ n = 20） , which was routine prospective ECG-gated coronary angiography. Group 3 underwent routine carotid and eerebrovaseular CTA （n = 20）. Mean CT image attenuation and image noise were measured in the ascending aorta root, proximal parts of the bilateral common carotid artery and vertebral artery, and in the internal carotid artery at sellae level in the axial plane. Coronary artery image quality was rated using a four-point ordinal scale and carotid cerebral vascular image quality was rated using a three-point ordinal scale. Radiation dose were calculated. Mean CT image attenuation, image noise and radiation dose were compared among the 3 groups using t test. Using Mann-Whitney U, the coronary artery imaging quality was compared between group 1 and 2, and image quality of cerebral vessels was compared between group 1 and 3. Results Mean CT image attenuation [ （427 ± 50） HU in group 1 and （426 ± 86） HU in group 2 ] and image noise of the ascending aorta root [ （30 ± 9） HU in group 1 and （31 ± 9） HU in group 21 showed no statistical difference between group 1 and 2 （t = 0. 058, -0. 325 ,P 〉 0. 05 ）. There were no non-diagnosis coronary segments in group 1 and 2. And coronary segments with excellent or good image quality reached 98. 1% （202/206） in group 1 and 99. 6% （244/245） in group 2. It showed no significant difference between group 1 and 2 （Z = - 0. 572, P 〉 0. 05 ）. There were significan

关 键 词：体层摄影术 X线计算机 冠状血管 脑血管循环 

分 类 号：R816.2[医药卫生—放射医学]