64层CT冠状动脉成像最佳重建时间窗的探讨  

Investigation of coronal arterial image quality of 64 detector row CT in optimal reconstruction of phase window

作　　者：杨燕[1] 吕红玲[2] 李国晖[1] 范云[1] 黄伟[1] 代孔灵[1] 周嫒捷[1] 何敬[1] 

机构地区：[1]云南省中医医院云南中医学院第一附属医院,云南昆明650021 [2]云南中医学院西内教研室,云南昆明650031

出　　处：《中国中西医结合影像学杂志》2016年第4期376-379,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：云南省中医医院/云南中医学院第一附属医院科研课题基金(2013YJ003)

摘　　要：目的 ：探讨不同心率及不同重建时相对64层CT冠状动脉血管成像图像质量的影响。方法：收集90例临床疑诊冠心病患者的冠状动脉CTA检查资料。按扫描时平均心率分组,对心动周期的R-R相位30%-90%间期,每间隔5%重建后进行血管分析及评分,获得回顾性心电门控最佳重建时相,并评价不同心率时的图像质量。结果：冠状动脉图像质量随心率增加而降低,两者呈负相关。心率〈70次/min时,冠状动脉最佳重建时间窗为R-R间期的70%-75%;心率70-79次/min时,冠状动脉最佳重建时相为R-R间期的60%-70%;心率〉80次/min时,冠状动脉最佳重建时相为R-R间期的40%-50%。左前降支在70%和75%R-R重建时相显示最佳,左回旋支在70%R-R时相显示最佳,而右冠状动脉在50%R-R时相显示最佳。结论 ：选择最佳重建时相、合理控制心率能够减轻运动伪影,明显提高冠状动脉成像质量,其中准确选择回顾性心电门控最佳重建时相是保证图像质量、准确诊断的重要因素。Objective：To evaluate the impact of different heart rate and the reconstruction of phase window on the image quality of coronary CT with 64 detector row coronary angiography. Methods：90 patients with suspected coronary heart disease received coronary angiography of 64 detector row CT,and the image post-processing was conducted according to the average heart scan packets：during the R-R cardiac cycle phase of 30% to 90% with increments of 5%,the optimal reconstruction of phase window with retrospective ECG-gated reconstruction phase was acquired,and evaluated the images quality under different heart rate. Results：The image quality degraded when the heart rate increases become lower,the heart rate and heart rate fluctuations were negatively correlated with the image quality（P〈0.001）. The best phase of coronary reconstruction phase was 70% -75%R-R interval when heart rate 〈70 beats/min;and that of 60% -70% R-R interval when heart rate was at 70 -79 beats/min;40% -50% R-R interval when heart rate 80 beats /min. Left anterior descending branch（LAD） in 70%,75% R-R reconstruction phase showed the best,Left circumflex branch（LCX） in 70% R-R reconstruction phase,and right coronary artery（RCA） in 50%R-R reconstruction phase. Conclusion：Optimal reconstruction phase and reduced heart rate fluctuations can significantly reduce cardiac motion artifacts and improve the image quality. Reasonable selection of reconstruction phase is an important factor in image quality and accurate diagnosis.

关 键 词：体层摄影术 X线计算机 冠状动脉造影 心率 R-R相位 

分 类 号：R541.4[医药卫生—心血管疾病]