双源CT在高心率检查者中冠脉成像质量及辐射剂量对比  

Compare Image Quality, Diagnostic Accuracy and Radiation Dose of Prospective and Retrospective Electrocardiogram（ECG） Gated Dual-Source Computed Tomography（DSCT）

作　　者：李春梅[1] 庄莹莹[2] 张涛[3] 耿海[3] 徐益明[2] 季乐新[3] 聂家秋[3] 

机构地区：[1]潍坊医学院影像学教研室,山东潍坊261053 [2]淮安市第一人民医院 [3]潍坊医学院附属潍坊市人民医院放射科

出　　处：《潍坊医学院学报》2012年第3期195-198,I0004,共5页Acta Academiae Medicinae Weifang

摘　　要：目的评价比较双源CT前置门控和回顾性门控扫描在高心率检查者中冠状动脉成像的图像质量及辐射剂量。办法选取临床行冠状动脉CT造影检查心率〉70次／min的检查者80例。40例行前置门控扫描，另40例行回顾性门控扫描。前置门控扫描根据BMI分为A，B两组进行适应性扫描。回顾性门控根据BMI分为C，D组，选取冠咏显示好的期相进行重建。采用4分法分析冠脉节段及图像质量，同时比较各组有效辐射剂量。结果各组年龄、性别、BMI、平均心率、心率变异率、图像噪声均具有良好的一致性。对2009段冠状动脉进行分析，A～D组合格率分别为82．7％（456,／552），83．9％（379／452），86．9％（502／578），85．1％（363／427），其中A组与C组、B组与D组合格率无统计学意义（P〉0．05）。A，B组有效辐射剂量分别为（3．06±0．84）mSv，（5．38±1．29）mSv，前置门控有效辐射剂量为（4．46±1．21）mSv，回顾性扫描C，D组分别为（7．90±2．01）mSv，（13．34±1．21）mSv，回顾门控有效辐射剂量为（13．08±3．19）mSv，分别降低44．3％和41．2％，平均降低63．O％．A组与C组、B组与D组比较辐射剂量存在统计学意义（P〈0．01）。，结论双源CT前置门控适应性扫描能够为冠脉检查提供足够的诊断信息，并能够明显降低辐射剂量，能够用于可疑冠脉疾病的筛选。Objective To compare image quality ,diagnostic accuracy and radiation dose of prospective and retrospective electro- cardiogram（ECG） gated dual-source computed tomography （DSCT）. Methods Eighty patients who umlerwent DSCT coronary angiography （DS-CTCA） with higil heart rate（ 〉 70bpm） were em＇olled in the study,40 were scanned by prospective scan and another 40 were analyzed by retrospectively gated CT scan. Forty patients were divided in two groups according to their BMI （ A, B ） receiving the adaptive sequential EC（, gated I）SCT scanning. Retrospective CT angiography was performed with DSCT in another 40 patients,who were divided into two groups according to their BMI too（ C, D）. The inmging quality of cornnary artery segments in the four groups was evahiated using a four-point grading scale by two independent reviewers. Patient radiation dose was calculated by multiplying dose length product by conversion coefficient of 0. 017. Results The age, sex, BMI, average heart rate, heart rate variability, image noise, had good consistency. Of 2009 coronary segments scored,excellent or good image quality（score of 1 or 2） was achieved 82.7% ,83.9% ,86.9% ,85.1% ,anti with no significant differences between A and C, B and D. Effective doses of prospective and retrospective gated scan were （ 3.06 ± 0.84 ） mSv, （ 5.38 ± 1. 29 ） mSv, （ 7.90 ± 2.01 ） rosy, （ 13.34 ± 1.21 ） mSv respectively（ P 〈 0.01 ）. Conclusion Prospective gate DSCT seanner can provide adequate eoronary diag- nostic information,while significantly reduce the radiation dose. It can be used for suspected coronary artery disease screening.

关 键 词：体层摄影术 X线计算机 冠状动脉 前置门控 图像质量 辐射剂量 

分 类 号：R445.3[医药卫生—影像医学与核医学]