256层 CT 冠状动脉成像在肥胖患者的应用  

Application of 256-slice coronary CT angiography in the obesity patient

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

机构地区：[1]西安交通大学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12期1989-1992,共4页Journal of Practical Radiology

基　　金：西安市卫生局科研项目（2013073）。

摘　　要：目的：研究256层冠状动脉 CT 成像在肥胖患者的应用。方法回顾性分析2011-2013在本院进行冠状动脉 CT 成像的166例肥胖患者（体质量指数 BMI≥30）临床和影像资料（166例中前瞻性心电门控扫描109例,回顾性心电门控扫描57例）。将冠状动脉成像图像分为优、良、可、差4等级,由2位医生独立观察 CT 冠状动脉图像质量。使用χ2或 t 检验比较分析不同门控方法、不同心率（≤70次/min、〉71次/min）、不同 kV 值（120 kV、140 kV）对图像质量的影响。结果前瞻性心电门控和回顾性心电门控在显示优秀图像、合格图像（优＋良图像）方面无显著性差异（P 〉0.05）。前瞻性心电门控在心率≤70次/min 组显示优秀图像优于心率〉71次/min 组（P 0.05）。回顾性心电门控不同心率组对显示优秀图像、合格图像方面无显著性差异（P 〉0.05）。前瞻性心电门控和回顾性心电门控在120 kV、140 kV 组内对显示成像质量均无显著性差异（P 〉0.05）。前瞻性心电门控扫描患者接受射线剂量明显低于回顾性心电门控扫描。结论肥胖患者冠状动脉256层 CT 成像检查应采用前瞻性心电门控扫描,应维持患者心率≤70次/min,采用120 kV 扫描,降低患者接受射线剂量。Objective To study the application of 256-slice coronary CT angiography in the obesity patient.Methods Clinical and image date of 1 66 obesity cases （BIM≥30）from 201 1 to 2013 in our hospital were retrospectively analysed.Among the 1 66 cases, prospective and retrospective electrocardiography gated group accounted for 109,57 respectively.According to the coronary CT an-giographic findings,image qualities were divided into four grades （the best,better,good and bad）,by the two radiologists independ-ently observation.The image qualities under different electrocardiography gated,different heart rate（≤70 beats per minute and 〉71 beats per minute）and different kV （120 kV and 140 kV）were statistictally compared with student χ2 test.Results there was no sig-nificant different on displaying the best or the best＋better images for prospective and retrospective electrocardiography gated 256-slice coronary CT angiography（P 〉 0.05 ）.On prospective electrocardiography gated coronary CT angiography,the image quality demonstrating the best image was more superior for ≤70 beats per minute group to 〉71 beats per minute group （P 0.05 ）.On retrospective electrocardiogrphy gated coronary CT angiography,there was no obvious different on demonstrating the image quality for different heart rate groups （P〉0.05）.There were no signifcicant different on demonstraling the image quality by using different kV value （120 kV and 140 kV） for both different elecrtrocardiography gated coronary CT angiographic groups（P 〉0.05）.The radiation dose for prospective electro-cardiogphy gated group was lower than that of retrospective electrocardiography gated group.Conclusion For 256-slice coronary CT angiography in the obesity patient,prospective electocardigraphy gated scan must be the first choice,contol the patient heart rate un-der 70 beats per minute and use 120 kV scan,in order to decrease the radiation dose.

关 键 词：冠状动脉 计算机体层成像 前瞻性心电门控 回顾性心电门控 射线剂量 

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]