双源CT低剂量自适应扫描序列在冠状动脉成像中的应用  

Value of low-dose adaptive cardio sequence scan for dual-source CT coronary angiography

作　　者：阎静[1] 成官迅[1] 刘国顺[1] 虞康惠[1] 

机构地区：[1]南方医科大学南方医院影像中心,广东广州510515

出　　处：《中国临床医学影像杂志》2012年第6期393-396,共4页Journal of China Clinic Medical Imaging

基　　金：广东省自然科学基金(S2011010003870);南方医科大学南方医院院长基金(2010B017)

摘　　要：目的：探讨双源CT低剂量自适应扫描序列在冠状动脉成像中的应用价值。方法：将51例行双源CT冠状动脉成像的患者（心率≥65 bpm）采用自适应序列门控扫描模式,数据采集期相根据屏气时心率设定：A组24例患者（65 bpm≤心率〈75 bpm）,采集期相设为70%R-R间期,B组27例患者（心率≥75 bpm）,采集期相设为40%R-R间期。管电压根据体质量指数（BMI）调整：BMI≥25 kg/m^2,120 kV;BMI〈25 kg/m^2,100 kV。分别对两组的图像质量和辐射剂量进行评价。结果：A组共评价299段冠状动脉,B组共评价345段冠状动脉。两组可评价的冠状动脉节段评分为3-4分者分别占91.3%和92.2%;评分为1-2分者右冠状动脉（RCA）最多,其次是左回旋支（LCX）;心率波动范围3-44 bpm。A组图像质量总体平均评分为（3.53±0.73）分,B组为（3.59±0.63）分。A组总体平均有效剂量为（2.85±0.93）mSv,B组为（3.10±0.86）mSv。结论：双源CT行低剂量自适应序列门控扫描能够显著降低辐射剂量,在心率≥65 bpm的患者中也可以获得满足临床诊断的图像质量。Objective： To evaluate the value of low-dose adaptive cardio sequence scan of dual-source CT angiography（DSCTA）.Methods： Fifty-one patients with heart rate（HR）≥65 bpm underwent DSCTA with adaptive cardio sequence.They were divided into two groups according to the average HR of patients： For group A with 65 bpm≤HR75 bpm,70% of R-R interval was used.For group B with HR≥75 bpm,40% of R-R interval was chosen.Patients with a body mass index（BMI）≥ 25 kg/m^2 were examined with a tube voltage of 120 kV,whereas BMI25 kg/m^2 were examined with 100 kV.Both image quality and radiation dose of the two groups were analyzed.Results： A total of 299 coronary artery segments were evaluated in group A and 345 segments in group B.The third and forth grade of the coronary segments for two groups were 91.3% and 92.2%;Right coronary artery（RCA） had the largest percentage of coronary segments in the first and second grade for two groups,and the next was left circumflex artery（LCX）;The range of heart rate was 3-44 bpm.The mean score of image quality of group A and group B was（3.53±0.73） and（3.59±0.63） scores,while the total mean effective dose was（2.85±0.93） mSv and（3.10±0.86） mSv.Conclusion： Low-dose adaptive cardio sequence scan for DSCTA can substantially reduce radiation exposure,and obtain good diagnostic image quality in patients with HR≥65 bpm.

关 键 词：冠状血管 辐射剂量 体层摄影术 X线计算机 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]