Flex Padding技术在高心率患者前瞻性冠状动脉CTA中的应用研究  

The Value of Dual Source CT Prospective ECG Gate Coronary Angiography Using Flex Padding in Patients with High Heart Rate

作　　者：谭四平[1] 沈比先[1] 薛水培[1] 刘康[1] 汪春荣[1] 贾飞鸽[1] 陈丽兴[1] 楚二伟[1] 

机构地区：[1]广东医学院附属南山医院影像科,深圳518052

出　　处：《临床放射学杂志》2013年第11期1650-1654,共5页Journal of Clinical Radiology

摘　　要：目的探讨双源CTFlexPadding技术在高心率患者前瞻性冠状动脉CTA中的应用价值。方法应用FlexPadding技术对60例高心率（心率I〉75次／min）患者行前瞻性冠状动脉CTA检查，另60例高心率患者行回顾性冠状动脉CTA检查。根据管电压及体重指数（BMI）将120例患者分为A、B、C、D四组，A、B组为前瞻性扫描，C、D组为回顾性扫描。分析直径≥1．5mm的冠状动脉节段的图像质量（1—4分），并记录辐射剂量，比较各组的图像质量及辐射剂量。结果A、B、C、D组的年龄、心率具有良好的一致性。A、B、C、D组的图像合格率分别为87．2％、89．9％、88．0％、90．9％，A与C、B与D组间的图像质量评分及血管密度、噪声无统计学差异（P〉0．05）。A、B组的有效辐射剂量（ED）分别为（1．69±0．85）mSv、（2．54±1．36）mSv。C、D组的ED分别为（7．28±2．38）mSv、（12．19±3．73）mSv。A组与C组比较，ED下降76．8％（t值=-8．035，P〈0．001）；B组与D组比较，ED下降79．2％（t值=-18．536，P〈0．001）。结论FlexPadding技术结合个体化选择管电压、管电流的前瞻性冠状动脉CTA应用于高心率患者是切实可行的，与回顾性扫描相比，辐射剂量显著下降，图像质量无明显差异。Objective To investigate the value of dual source CT （DSCT） prospective ECG gate coronary angiography using Flex Padding in patients with high heart rate. Methods 60 patients with high heart rate（ HR ≥ 75bpm） underwent prospective ECG-gate coronary angiography using Flex Padding, another 60 patients with high HR were retrospective scanned. All cases were divided into A, B, C, D groups which based on tube voltage, and body mass index （BMI）. Group A and B were prospective scanned. Group C and D were retrospective scanned. The imaging quality of coronary artery segments which diameter larger than 1.5 mm was evaluated. Image quality and radiation dose were compared. Results The patients age and heart rate had a good consistency in group A, B, C, D. Excellent or good image quality （score of 3 or 4） were achieved 87.2% ,89.9% ,88.0% ,90.9% in group A, B, C and D, respectively. In image quality scores, vascular density and noise had no significant differences between A, B, C, D （P 〉 0.05 ）. The effective radiation dose （ED） were （1.69 ±0.85）mSv, （2.54±1.36） mSv, （7.28 ±2.38） mSv, （12.19 ±3.73） mSv in group A, B, C, D, respectively. The radiation doses were reduced 76.8% , 79.2% , respectively between group A and C （ t = - 8. 035, P 〈 0. 001 ）, B and D（t = -18. 536, P 〈0. 001 ）. Conclusion Prospective ECG gate CT coronary angiography using Flex Padding combined with individualized tube voltage and current are suitable for patients with high HR, and the radiation close is significantly reduced. The image quality is not statistical significant between prospective and retrospective scan.

关 键 词：体层摄影术 X线计算机 冠状动脉造影术 心电脉冲 曝光时间 

分 类 号：R816.2[医药卫生—放射医学]