双源CT自适应前瞻性心电门控冠状动脉成像技术初步研究  

Adaptive cardio sequence prospective ECG-gated dual-source CT coronary artery imaging: An initial investigation

作　　者：陈新[1] 张军[1] 周长圣[1] 顾海峰[1] 刁强[1] 郑玲[1] 

机构地区：[1]南京军区南京总医院医学影像科,南京210002

出　　处：《医学研究生学报》2012年第10期1065-1068,共4页Journal of Medical Postgraduates

摘　　要：目的自适应前瞻性心电门控扫描技术是冠状动脉CT血管成像(computed tomogrophy angiography,CTA)中应用的新技术。文中旨在探讨双源CT自适应前瞻性心电门控技术冠状动脉成像的初步经验。方法自2010年7月至2011年3月,56例冠心病患者纳入研究,进行自适应前瞻性心电门控技术双源CT冠状动脉成像。将患者分为2组,A组患者心率平均≤75次/min,选择70%期相进行扫描;B组患者心率平均>80次/min,选择40%期相进行扫描。2组注射对比剂为80～90 ml。由2名有经验的影像医师利用双盲法以4分法评定系统进行影像评分,对冠状动脉3个主要分支即右侧冠状动脉、左侧冠状动脉前降支、回旋支血管成像质量进行评分,并记录辐射剂量。采用两样本均数比较的t检验比较2组间图像质量差异。结果 56例患者共纳入分析的血管为168支,共有156支(92.9%)冠状动脉满足影像诊断要求。其中A组30例患者90支血管,其中4支(4.44%)冠状动脉不能评价;B组26例患者共计78支血管,其中8支(10.3%)血管不能评价;在A、B 2组各段冠状动脉图像质量对照,2组图像质量差异无统计学意义(P>0.05)。总辐射剂量(CT dose index volume,CTDIvol)均值(17.28±0.45)mGy,有效辐射剂量(effective dose,ED)(2.84±0.08)mSv,其中A组CTDIvol均值(17.38±0.73)mGy、ED(2.90±0.13)mSv;B组CTDIvol均值(17.17±0.47)mGy,ED(2.77±0.09)mSv。结论采用双源CT自适应前瞻性心电门控技术冠状动脉成像,按照平均心率≤75次/min,选择70%期相进行自适应前瞻性扫描,平均心率>80次/min,选择40%期相进行自适应前瞻性扫描的原则,可得到满足临床诊断要求的冠状动脉图像,并大大降低了患者辐射剂量。Objective Adaptive cardio sequence prospective ECG-triggering coronary angiography is a novel technique ap- plied in CT coronary artery imaging. This article aimed to investigate the scanning program of dual source CT （DSCT） adaptive eardio sequence prospective ECG-triggering coronary angiography. Methods Fifty-six patients with coronary heart diseases were divided in- to groups A （ heart rate ≤75 bpm） and B （ heart rate 〉 80 bpm） to receive DSCT prospective ECG-triggering coronary angiography scanning at 70% and 40% of R-R interval, respectively, using 80 to 90 ml contrast medium. Two experienced radiologists evaluatedthe image quality of the 4 segments of coronary arteries on the four score scale using double-blind method, and compared them between the two groups. Results Of the 168 segments from the 56 patients, 156 （92.9%） had assessable and 12 （7.14%） non-assessable im- age quality. Non-assessable quality was observed in 4 （4.44%） ofthe 90 segments in group A, and 8 （ 10.3% ） of the 78 segments in group B. There were no statistically significant differences between the two groups in the image quality （ P 〉 0.05 ）. The total CT dose index volume was （ 17.28 ：l： 0.45 ） mGy （ [ 17.38 ＋ 0.73 ] mGy in group A and [ 17.17 ＋ 0.47 ] mGy in group B）, and the total effective dose was （2.84 ＋ 0.08） mSv （ [ 2.90 ＋ 0.13 ] mSv in A and [ 2.77 ＋ 0.09 ] mSv in B）. Conclusion During DSCT prospective ECG-triggering coronary angiography scanning, 70% of R-R in- terval for those with heart rate ≤75 bpm and 40% of R-R interval for those with heart rate 〉80bpm can achieve satisfactory images of the coronary artery for clinical diagnosis and largely reduce the radiation dose.

关 键 词：自适应前瞻性心电门控 冠状动脉成像 双源CT 

分 类 号：R816.2[医药卫生—放射医学]