双源CT冠状动脉造影在心律失常患者的临床应用  

Clinical Application of Dual-source CT Coronary Angiography in Patients with Arrhythmia

作　　者：胡春峰[1] 徐凯[1] 袁莹莹[1] 汪秀玲[1] 李绍东[1] 程广军[1] 谢丽响[1] 

机构地区：[1]徐州医学院附属医院放射科

出　　处：《中国医学计算机成像杂志》2012年第4期312-316,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨双源CT冠状动脉造影(DSCT-CA)在心律失常患者中的临床应用价值。方法:行DSCT-CA的心律失常患者共73例(室性期前收缩29例,房性期前收缩25例,心房纤颤19例),采用回顾性心电门控重建图像及心电编辑技术,对各段血管图像质量分级,比较无需编辑组与需编辑组的平均心率及心率波动、需编辑组各段冠状动脉编辑前后的图像质量。结果:73例中14例为无需编辑组,59例为需编辑组。无需编辑组的平均心率、心率波动均明显低于需编辑组(P<0.05)。心电编辑后各段冠状动脉图像优良率明显提高(P<0.05),11段(11/823)未达诊断要求。结论:双源CT冠状动脉造影可用于心律失常患者,具有重要的临床应用价值,心电编辑能够明显提高心律失常患者的冠状动脉血管成像质量,但是控制心率和心率变化仍是提高图像质量的关键。Purpose： To study the clinical application value of dual-source CT coronary angiography （DSCT-CA） in patients with arrhythmia. Methods： Seventy-three patients with arrhythmia （29 patients with ventricular extrasystoles, 25 with atrial extrasystoles, 19 with atrial fibrillation） underwent DSCT- CA in this study. Retrospective gating technique and ECG editing technique were used. Coronary segment image quality was evaluated by four-grade method. Average heart rate and heart rate variability between ECG-editing group and no ECG- editing group and the image quality of pre-editing and post-editing in ECG-editing group were compared respectively. Results： In 73 patients, ECG-editing was not needed in 14 patients, and ECG-editing was needed in 59 patients. The average heart rate and heart rate variability between ECG-editing group and no ECG-editing group was with significant difference （P〈 0.05 ）. The image quality in every segment of ECG-editing group between pre-editing and post-editing was also with significant difference （ p 〈 0.05 ）. After ECG-editing, 11 segments did not reach diagnosis requirements. Conclusion： DSCT-CA can be used in patients with arrhythmia. The image quality of coronary artery could be significantly improved with ECG-editing in patients with arrhythmia, but the key to improve the quality of image is to control heart rate and heart rate variability.

关 键 词：冠状动脉造影 心律失常 体层摄影术 X线计算机 心率变化 

分 类 号：R816.2[医药卫生—放射医学] R541.7[医药卫生—临床医学]