优化CTA技术在婴幼儿复杂先天性心脏病术前诊断的研究  

Optimization of CTA Techniques in the Preoperative Diagnosis of Complicated Congenital Heart Disease in Infants and Young Children

作　　者：张晓凡 王志伟 郝明珠 王芳 卓芝政 张毅 刘鑫春 徐守成 

机构地区：[1]黑龙江省哈尔滨市儿童医院影像科,黑龙江哈尔滨150010

出　　处：《中国CT和MRI杂志》2016年第11期47-49,87,共4页Chinese Journal of CT and MRI

基　　金：2013年哈尔滨市科技攻关计划项目:2013AA3BS018

摘　　要：目的探讨优化低剂量CTA方案在小儿先天性心脏病（CHD）术前检查的临床价值。方法 CHD患儿139例（年龄1天-6岁）,根据患儿就诊时间分别采用前门控和高级混合迭代重建技术（i Dose4）、前门控和滤波反投影重建（FBP）、非门控和FBP进行CTA检查。采用方差分析及Post-Hoc双样本T检验对每组患儿有效射线辐射剂量及图像质量进行对比分析;并以手术结果为诊断标准,采用CTA诊断结果与超声心动图（UCG）诊断结果进行符合一致性分析。结果 1.有效射线辐射剂量：前门控i Dose4组较前门控FBP组降低13.8%、前门控i Dose4组较非门控FBP组降低23.5%（P〈0.05）。2.图像质量评估：前门控i Dose4组、前门控FBP组、非门控FBP组分别为：Ⅲ级36、57、12例;Ⅱ级0、25、8例,（χ~2=15,.879,P〈0.05）。3.经手术治疗的CHD患儿（n=102）,术前CTA、UCG诊断结果与手术结果对比：CTA总诊断符合率94.5%（P〈0.001）,UCG诊断符合率90.4%（P〈0.001）。结论低剂量前门控i Dose4 CTA技术在小儿CHD的术前应用具有重要临床意义。Objective Evaluate the preoperative clinical value of optimized low-doses CTA examination in children with congenital heart disease（CHD）. Methods 139 children with CHD（aged 1 day-6 years） were included in this study, CTA examinations based on 3 different techniques including the front door and high-level mixed iterative reconstruction technique（i Dose4）, the front door and filter back projection reconstruction place place（FBP） and gate control and FBP were carried out on these children according to the patient＇s clinical visiting time. Statistical analysis including the analysis of variance and Post Hoc-two sample T test were performed to compare the effective radiation dose and image quality. The results of surgery were taken as the diagnostic criteria, and consistency analysis were used to evaluate the CTA diagnosis and echocardiography（UCG） diagnosis respectively. Results 1.Results on effective radiation dose： the front door i Dose4 control group was 13.8% lower than the front door place control FBP group, the front control i Dose4 place was 23.5% lower than a non-gate control FBP group（P〈0.05）.2. Results on image quality assessment： the front door place controlled i Dose4 group, the front door FBP group place, non-gate control FBP respectively： Ⅲ level 36, 57, 12 cases, ⅡLevel 0, 25, 8 cases（χ~2=15, 879, P〈0.05）.3. Results on the consistency with surgical results： 102 children were carried out the surgical treatments, consistencies of preoperative CTA and UCG diagnosis were as follows： CTA total diagnostic coincidence rate 94.5%（P〈0.001）, the UCG diagnosis coincidence rate 90.4%（P〈0.001）. Conclusion Low doses of front door control i Dose4 CTA technology has important preoperative clinical significance in children with CHD.

关 键 词：小儿先天性心脏病 心电门控 迭代重建 辐射剂量 

分 类 号：R541.4[医药卫生—心血管疾病]