心电前门控冠状动脉CT成像在快心率患者中的应用对策  

Strategies for the application of prospectively gated coronary CT imaging in patients with rapid heart rate

作　　者：孙红[1] 王新江[1] 惠萍[1] 姚洪祥[1] 王新明[1] 

机构地区：[1]解放军总医院南楼放射诊断科,北京100853

出　　处：《中华老年心脑血管病杂志》2013年第12期1238-1240,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：全军医药卫生科研基金(IIBJZ20)

摘　　要：目的探讨通过增加padding的方法，评估64层螺旋CT前门控冠状动脉CT成像在相对快一心率患者的应用价值。方法选择心率〉65／min患者30例（病例组），通过增加padding至180ms，重建40％～80％相位，评价冠状动脉图像质量，分析有效辐射剂量，并与30例（对照组）用回顾性心电门控螺旋CT冠状动脉重建方法辐射剂量进行对比。结果98．3％的冠状动脉血管能够满足诊断要求，其中通过增加padding重建收缩期40％～45％相位窗，28．3％的冠状动脉血管图像质量改善，其中7例患者（23．3％）的12支血管（10．0％）图像质量由不能诊断改善为可以用于诊断；病例组平均辐射剂量明显低于对照组（3．5mSvs10．1mSv，P〈0．01）。结论前门控轴扫增加padding用于相对快心率患者，可改善图像质量，避免用辐射剂量更高的回顾性心电门控螺旋CT扫描方法。Objective To assess the value o{ 64-slice spiral prospectively gated coronary CT ima- ging in patients with high heart rate （HR） by increasing the padding duration. Methods Thirty patients with their HR 〉 65/rain served as an experimental group and 30 patients with their HR ≤65/min served as a control group in this study. The 40%-80% phase window was recon- structed in patients of experimental group by increasing the padding duration to 180ms with 60% R-R interval as the center for the assessment of their coronary image quality and the analysis of their effective radiation dose which was compared with that in patients of control group whose 40%-80% phase window was reconstructed by retrospectively gated spiral coronary CT ima ging. Results Of the 98. 30/00 coronary vessels that could meet the diagnostic requirements, the 40%-45% phase window was reconstructed in systolic phase, and 28.3% coronary images were improved. Of these improved coronary images, 12 coronary images （10.0%） in 7 patients （23.3%） could meet the diagnostic requirements. The mean radiation dose was significantly lower in experi- mental group than in control group （3.5 mSv vs 10.1 mSv, P〈0.01）. Conclusion Combined pro- spectively gated coronary CT imaging and increased padding duration can improve the image qual ity in patients with rapid HR and avoid the higher radiation dose required in retrospectively gated spiral CT scanning.

关 键 词：体层摄影术 螺旋计算机 心率 辐射剂量 心电描记术 

分 类 号：R816.2[医药卫生—放射医学]