超声引导下心电门控冠状动脉CT造影的应用  

The application of coronary CT angiography incorporating Doppler-guided prospective electrocardiograph gating

作　　者：翟继良[1] 周涛[2] 李统[3] 李新勃 彭兆辉[3] 李敏[3] 孙钢[3] 

机构地区：[1]泰安市中心医院分院放射科,山东泰安271000 [2]莱芜市人民医院影像科 [3]济南军区总医院医学影像科

出　　处：《实用放射学杂志》2016年第9期1447-1450,共4页Journal of Practical Radiology

摘　　要：目的 探讨在心率＞65次/min的人群中，通过超声多普勒引导前瞻性心电门控，评价其冠状动脉CT造影的有效辐射剂量和诊断准确性。方法 126例患者随机分为传统组（n=64）和多普勒组（n=62），传统组的心电门控曝光窗口设置在心动周期的30%～80%；多普勒组中，由超声分析最佳曝光时相，当等容舒张期长度＞90 ms，最佳窗口设置在舒张期的60%～80%，否则设置在收缩期的30%～50%。结果 在传统组与多普勒组之间，图像质量（F=1.54,P=0.42）无显著性差异，但多普勒组剂量比传统组显著降低［（5.5±3.3）mSv vs （9.7±4.0）mSv，F=41.67,P＜0.001］。结论 超声多普勒引导下的前瞻性心电门控是一种技术的改进，对于具有较高心率的患者，可以有效降低辐射剂量，同时又能保证较高的诊断准确性。Objective To evaluate the effective dose and diagnostic accuracy of coronary CT angiography incorporating Doppler- guided prospective electrocardiograph （ECG） gating, which resets pulsing windows according to Doppler analysis, in patients with heart rate 〉65 beats per minute. Methods 126 patients were randomly divided into traditional prospective （n=64） and Doppler-guided prospective （n= 62） ECG gating groups. For traditional group, the exposure window was set at 30%- 80 % of the cardiac cycle. For Doppler group, the length of diastasis was analyzed by Doppler. If the lengths were greater than 90 ms, the pulsing window was reset during diastole （during 60%-80% ） ;Elsewise, the pulsing window was moved to systole （ during 30%- 50%）. Results Between traditional and Doppler groups the image quality showed no significant difference（F= 1.54, P= 0.42）, while the radiation dose of the Doppler group was significantly lower than that of the traditional group [ （ 5.5±3.3 ） mSv vs （9.7±4.0） mSv,F= 41.67,P〈0. 001]. Conclusion The patients with a high heart rate, Doppler-guided prospective ECG gating stands for an improved method which reduces effective radiation doses, while guaranteeing high diagnostic accuracy.

关 键 词：冠状动脉 计算机体层成像 超声多普勒 血管造影术 心电门控 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.1[医药卫生—放射医学]