256层计算机断层扫描回顾性心电门控及非门控螺旋分段扫描法评价主动脉全程和冠状动脉  

Evaluation of subsection scanning with retrospectively electrocardiographically-gated 256-slice computed tomography on entire aorta and coronary arteries

作　　者：王振邦[1] 郑君惠[1] 曹希明[1] 崔燕海[1] 李新云[1] 钟小梅[1] 

机构地区：[1]广东省人民医院放射科(广东省医学科学院),广州510080

出　　处：《岭南心血管病杂志》2015年第6期819-823,共5页South China Journal of Cardiovascular Diseases

基　　金：广东省科技计划项目(项目编号:2011B061300018)

摘　　要：目的探讨256层计算机断层扫描(computed tomography,CT)回顾性心电门控及非门控螺旋分段扫描法评价主动脉全程和冠状动脉的应用价值。方法收集疑似主动脉夹层患者60例,分为A组(扫描时分为胸主动脉段和腹主动脉段,胸主动脉段采用回顾性心电门控扫描,腹主动脉段用非门控螺旋扫描)30例和B组(全程用非门控螺旋扫描)30例,比较两组间主动脉全程及冠状动脉的图像质量,为手术提供夹层破口及冠状动脉病变情况等,以帮助手术顺利进行。结果A组和B组主动脉全程图像质量评分比较,差异无统计学意义[(1.17±0.38)分vs.(1.13±0.35)分,P>0.05]。A组和B组冠状动脉图像质量评分比较,差异有统计学意义[(3.50±0.82)分vs.(1.10.±0.31)分,P<0.05]。A组和B组气管叉层面主动脉CT值比较,差异无统计学意义[(334.4±58.6)HU vs.(324.0±64.6)HU,P>0.05]。两组左侧冠状动脉开口层面CT值比较,差异无统计学意义[(347.7±56.7)HU vs.(321.0±74.1)HU,P>0.05]。A组和B组右肾动脉开口层面CT值比较,差异有统计学意义[(269.4±69.1)HU vs.(319.1±71.2)HU,P<0.05]。结论 256层CT回顾性心电门控及非门控螺旋分段扫描法和全程非门控螺旋不分段扫描法在主动脉全程CT成像中都能保证主动脉图像的质量,满足对主动脉的诊断要求,但当采用回顾性心电门控及非门控螺旋分段扫描法时,可以在保证主动脉全程图像质量的同时得到满意的冠状动脉图像,同时评价主动脉全程及冠状动脉,值得临床推广应用。Objectives To explore the evaluation of subsection scanning with retrospectively electrocardiographically （ECG）-gated 256-slice computed tomography （CT） on the entire aorta and coronary arteries. Methods Totally 60 patients with suspected aortic dissection were randomly divided into two groups, with 30 patients in each group. In segmented scanning group, thoracic aortic segment was scanned with retrospectively ECG gated CT and abdominal aortic segment was scanned with non-ECG-gated CT. In non-segmented scanning group, the entire aorta was scanned with non-ECG-gated CT. The image quality of the entire aorta and coronary arteries was compared between the two groups. Results The difference in image quality of the entire aorta between segmented scanning group and non- segmented scanning group was not statistically significant [ （1.17±0.38） vs. （1.13±0.35）, P〉0.05]. There were significant differences in image quality of coronary arteries between segmented scanning group and non-segmented scanning group [ （3.50±0.82） vs. （1.10±0.31） ,P〈0.051. CT values of aorta at trachea branch angle and left coronary artery open-angle had no statistical differences between the two groups [ （334.4±58.6） HU vs. （324.0±64.6） HU, P〉 0.05; （347.7±56.7） HU vs. （321.0±74.1）HU,P〉O.05 ]. CT value of right renal artery open-angle between the two groups had significant difference [（269.4±69.1） HU vs. （319.1±71.2） HU, P〈0.05]. Conclusions The image quality of the entire aorta in both methods can attain satisfactory diagnosis outcomes. Retrospectively ECG CT can additionally guarantee the image quality of coronary arteries. It is worth to populate and apply.

关 键 词：体层摄影术 X线计算机 主动脉夹层 冠状动脉 

分 类 号：R540.4[医药卫生—心血管疾病]