256层螺旋CT三联检查在急性胸痛诊断中的临床应用价值  

Clinacal value of 256-slice spiral CT triple examination in the diagnosis of acute chest pain

作　　者：张芝[1] 刘涛 付建立[3] 张伟[1] 

机构地区：[1]山东单县中心医院放射科,山东单县274300 [2]山东单县东大医院放射科,山东单县274300 [3]山东单县中心医院CT室,山东单县274300

出　　处：《医学影像学杂志》2017年第5期829-833,共5页Journal of Medical Imaging

摘　　要：目的分析探讨256层MSCTA三联检查的临床应用价值,同时分析患者接受的辐射剂量,为开展低剂量MSCTA检查提供依据。方法 50例三联检查患者为研究组,单纯256层MSCTA冠脉成像40例,CTPA30例,主动脉成像20例,作为对照组,两组进行分析比较,评价其成像质量是否可以满足影像诊断及临床需要。同时计算患者接受的辐射剂量。对所有数据输入Stata统计软件进行统计学分析,P<0.01有差异,具有统计学意义。结果胸痛三联检查成像质量与对照组比较,无显著统计学意义(P>0.05)。关于辐射剂量,研究组与主动脉组、肺动脉组两两对照比较,无显著性统计学差异(P>0.05),但研究组与单独的冠状动脉组相比,有统计学意义(P<0.01)。结论 256层MSCTA及其后处理技术在急性胸痛患者检查中可同时显示冠状动脉、主动脉、肺动脉及其分支图像,其成像质量与单纯冠状动脉、主动脉、肺动脉成像检查比较无显著性差异,此检查具有重要的临床应用价值。尽管MSCT三联检查射线剂量比单纯冠状动脉、主动脉、肺动脉检查为高,但要比三种造影分开检查所受剂量总和低得多。Objective To analyze and investigate the clinical value of 256-slice MSCTA triple examination. At the same time, we analyzed the radiotion dose to provide evidence for low-dose MSCTA inspection. Methods We collected 50 patients of triple examination as study group, compared to 40 eases with pure 256-slice MSCT coronary angiography, 30 cases with pulmonary arter- y imaging and 20 eases with aortic imaging. The results from the above examinations were analyzed to evaluate whether or not the quality of the images could meet the need of the clinical diagnosis. At the same time, we calculated the radiation dose. Analyses were performed using the statistical software （SPSS, version 16 for Windows）. A P value less than 0.01 was indicative of a statis- tically significant difference. Results The imaging quality of triple examination was compared with control group, there was no significant differeneeere （ P 〉 0.05 ）. As for radiation dose, when study group compared with coronary group, there was statisti- cally significant （ P 〈 0.01 ） ; But for the study group and the group aorta, pulmonary artery group, there was no significant difference （ P 〉 0. 05）. Conclusion The examination of 256-slice CT can show coronary artery, pulmonary artery, aorta at the same time. The image quality of coronary artery, aorta and pulmonary artery are all excellent. There is no significant difference between the image quality of the single coronary artery, aorta imaging and the unified examination of the MSCT, which has impor-tant clinical value. Although the radiation dose in MSCT chest pain triple check than simply coronary arteries, the aorta and pul- monary examination is high and the three kinds of contrast are much lower doses examined separately. This provides a basis for clinic in low-dose MSCTA examination.

关 键 词：胸痛三联征 心肌梗死 肺动脉栓塞 主动脉夹层 体层摄影术 X线计算机 

分 类 号：R542.2[医药卫生—心血管疾病] R814.42[医药卫生—内科学]