不同心率单个心动周期冠状动脉CT成像质量和辐射剂量研究  

Investigation of image quality and radiation dose of coronary CT angiography in a single cardiac cycle with different heart rate

作　　者：刘军波[1] 范丽娟[1] 周伟[1] 管延芳[1] 凌坚 Liu Junbo;Fan Lijuan;Zhou Wei;Guan Yanfang;Ling Jian(Department of Radiology,TEDA International Cardiovascular Hospital,Tianjin 300457,China)

机构地区：[1]泰达国际心血管病医院放射科,天津300457

出　　处：《中华放射医学与防护杂志》2019年第2期150-154,共5页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的研究受检者不同心率宽体探测器CT单个心动周期冠状动脉CT成像(CCTA)的图像质量和辐射剂量。方法连续选取泰达国际心血管病医院临床疑似冠状动脉病变行CCTA检查的患者821例,检查前均不给予降心率药物,根据心率不同将受检者分为6组,A组(心率≤65次/min)132例;B组(心率66~75次/min)244例;C组(心率76~85次/min)145例;D组(心率86~95次/min)101例;E组(心率96~105次/min)101例;F组(心率106~135次/min)98例,比较6组CCTA图像主动脉根部CT值、前降支(LAD)和右冠状动脉(RCA)中段CT值、信噪比(SNR)、对比噪声比(CNR)、有效辐射剂量(E)客观指标差异,以及6组冠状动脉可诊断血管和评分等主观指标的差异。结果6组图像质量客观指标均差异无统计学意义(P>0.05);6组LAD、LCX和RCA的可诊断血管差异无统计学意义(P>0.05),但6组LAD、LCX和RCA4分(优秀)差异有统计学意义(χ2=27.614、58.475、39.571,P<0.05);6组辐射剂量差异均有统计学意义(F=37.32,P<0.05),B组辐射剂量最高,D组、E组和F组辐射剂量较低。结论不同心率宽体探测器CT单个心动周期CCTA成像可以满足临床诊断,但是随着心率的升高图像质量下降,高心率组(心率>85次/min)辐射剂量最低。Objective To investigate the image quality and radiation dose of coronary computed tomography argiograply(CCTA) with wide-body detector CT in single cardiac cycle with different heart rate. Methods A total of 821 patients with clinically suspected coronary artery lesions were performed CCTA examination continuously. They were divided into six groups: group A (<65 bpm) with 132 cases, group B (66-75 bpm) with 244 cases, group C (76-85 bpm) with 145 cases, group D (86-95 bpm) with 101 cases, group E (96-105 bpm) with 101 cases and group F (106-135 bpm) with 98 cases. The CT values of the aorta root and the middle segment of LAD and RCA, the signal to noise ratios (SNRs), the contrast noise ratios (CNRs), the effective doses (E), the diagnostic rates and scores were compared among six groups of CCTA images. Results There was no significant difference in objective quality between the six groups (P>0.05). There was no significant difference in the diagnostic rates of LAD, LCX and RCA (all P>0.05). However, there were significant differences in LAD, LCX and RCA with 4 points (excellent) among the six groups(χ2=27.614, 58.475, 39.571, P<0.05). There were significant differences in radiation dose among the 6 groups (F=37.32, P<0.05). The radiation dose of group B was highest, and that of group D, group E and group F was the lowest. Conclusions The CCTA images with wide-body detector CT in single heart cycle with different heart rate can meet the clinical diagnostic requirements, but image quality declined with heart rate increasing. The higher heart rate groups (heart rate > 85 beats/min) had lower radiation doses.

关 键 词：计算机成像 冠状动脉 心率 辐射剂量 

分 类 号：R816.2[医药卫生—放射医学] R543.3[医药卫生—临床医学]