前瞻性与回顾性心电门控技术256层CT冠状动脉支架成像质量的对比研究  

Prospective and retrospective ECG-gated 256-slice CT of coronary stenting： comparison study

作　　者：姚果林 霍蛟 高艳妮[1] 裘晟[1] 王飞[1] 杨欢[1] 张静[1] 杨小军[1] 姚晓群[1] 杨广夫[1] 

机构地区：[1]西安交通大学医学院附属西安高新医院影像科,陕西西安710075

出　　处：《实用放射学杂志》2014年第11期1902-1905,共4页Journal of Practical Radiology

基　　金：西安市卫生局科研项目（2013-073）.

摘　　要：目的比较前瞻性和回顾性心电门控技术在256层CT冠状动脉支架成像的图像质量及剂量中的价值。方法回顾性分析161例临床冠心病支架术后256层CT冠状动脉成像在稳定心率情况下，成像质量将前瞻性心电门控、回顾性心电门控扫描病例分2组。图像质量分为优、良、一般、差4等级，对其结果进行对比，并对比2种门控辐射剂量差异。结果161例中，87例（158枚支架）前瞻性心电门控，74例（159枚支架）回顾性心电门控。优秀图像分别为30例（34．5％）、9例（12．2％）（χ^2=10．853，P=0．001）；良好图像分别为45例（5l.7％）、41例（55．4％）（χ^2=0．218，P=0．641）；一般图像分别为12例（13．8％）、21例（28．4％）（χ^2=5．22，P=0．022）；较差图像分别为0例（0．0％）、3例（4．0％）（χ^2=1．719，P=0．190）。前瞻性和回顾性电门控辐射剂量分别为5．3074mSv、17．564msv（z=10．919，P=0．001）。前瞻性心电门控辐射剂量较回顾性心电门控辐射低约69．8％。结论在稳定心率情况下，前瞻性心电门控图像质量优于回顾性心电门控，而且射线剂量明显减小。Objective To compare image quality and radiation dose of prospective and retrospective electrocardiogram （ ECG ）-gated 256-slice CT angiography in evaluation of coronary stent. Methods ECG-gated 256-slice CT angiography images of 161 cases of coronary heart disease（ CHD） patients after stent operation were retrospective analysed, in which patients with stable heart rate were divided into prospective ECG-gated group and restrospective ECG-gated groups. Accooding to normal blood vessels and stent image display, the image quality was divided into four grades： the best, better, good, poor grade, and the quality results were compared. The radiation doses were compared between the two ECG-gated groups. Results In 87 cases （158 stents） of prospective ECG gated CT angiography group and 74 cases （159 stents） restrospective ECG-gated CT angiography group the best images were 30 cases （34.5%） and 9 cases （12.2%） （χ^2= 10.853 ,P=0. 001） ,better images 45 cases （51. 7 %） and 41 cases （55.4%） （χ^2 =0. 218,P=0. 641） ,good images 12 cases （13.8%） and 21 cases （28.4 %） （χ^2=5.22 ,P=0. 022） ,poor images 0 case and 3 cases（4.0%） （χ^2 = 1. 719 ,P=0. 190） respectivity. The radiation dose median for prospective ECG-gated angiography group and retrospective ECG-gated angiography group was： 5. 307 4 mSv, 17. 564 mSv （z = - 10. 919, P = 0. 001）. The radiation dose of prospective ECG-gated angiography is decreased by 69.8%. Conclusion For 256-slice CT of coronary stent patient with stable heart rate,image quality of prospective ECG-gated angiography is much better than that of retrospective ECG gated angiography, and the radiation dose of prospective ECG-gated angiography is evident decreased.

关 键 词：冠状动脉支架 计算机体层成像 心电门控 图像质量 

分 类 号：R322.121[医药卫生—人体解剖和组织胚胎学] R814.42[医药卫生—基础医学]