不同扫描触发阈值设定对双能量冠状动脉CT血管成像效果的影响  

Effect of different enhancement scanning triggering threshold on dual energy coronary CT angiography image quality： an exploratory study

作　　者：潘存雪 索伦格 党军 刘文亚 Pan Cunxue;Suo Lunge;Dang Jun;Liu Wenya(Imaging Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Chin)

机构地区：[1]新疆医科大学第一附属医院影像中心,乌鲁木齐830054

出　　处：《中华放射学杂志》2018年第2期96-102,共7页Chinese Journal of Radiology

基　　金：新疆维吾尔自治区自然科学基金（2013211A083）

摘　　要：目的通过对双能量冠状动脉CT血管成像（DE-CCTA）不同扫描触发阈值下，冠状动脉、心肌成像质量的综合评价及对比分析，寻找冠状动脉、心肌最优显示的增强扫描时机。 方法连续收集2013年6月至10月因体检或疑似冠心病于我院影像中心行DE-CCTA检查的患者135例，纳入其中100例并随机均等分至5个不同扫描触发阈值（ESTT）组，分别为100、110、120、130、140 HU；对5组图像冠状动脉及心肌的噪声、信噪比（SNR）、对比噪声比（CNR）、强化幅度以及左心室强化幅度、心肌碘值、心肌射线硬化伪影（BH）进行测量比较。其中计量资料各组数据均符合正态分布，且方差齐，采用多个独立样本比较的方差分析，两两比较采用SNK法；心肌BH主观评分为等级资料，采用[中位数（P25，P75）]表示，采用Kruskal-Wallis检验，两两比较采用Nemenyi检验。结果（1）左前降支增强扫描CT值及左心室腔的增强扫描CT值、增强扫描与平扫CT值的差值在不同ESTT组间的差异具有统计学意义（F值分别为3.471、3.795、3.132，P值均〈0.05）。两两比较结果显示，ESTT为130 HU时增强扫描左前降支CT值[（355.2±59.1）HU]低于ESTT为100 HU时[（404.9±49.0）HU]。（2）心肌BH客观测量值及主观评分在不同ESTT组间的差异具有统计学意义（F=6.118，H=13.702；P值均〈0.05）。两两比较结果显示，ESTT为130、140 HU的心肌BH值[（8.8±12.4）、（5.4±17.1）HU]低于ESTT为100、110 HU的心肌BH值[（24.2±17.7）、（22.1±11.6）HU]，ESTT为130 HU的心肌BH主观评分[1.5（1.0，2.0）分]低于ESTT为100 HU[2.5（2.0，4.7）分]、110 HU[3.0（2.0，3.0）分]的心肌BH主观评分。（3）左心室外侧壁心肌的增强扫描CT值、碘值、增强与平扫CT值的差值、前降支增强前后CT值的差值以及左前降支和左心室外侧壁增强扫描的噪声、SNR、CNR在不同扫描ESTT间的差异均无统计学意�ObjectiveTo define the optimal enhancement scanning triggering threshold （ESTT） for both coronary and myocardial imaging of dual energy coronary computed tomography angiography （DE-CCTA）.MethodsOne hundred of 135 patients who were going to receive DE-CCTA were enrolled in this study prospectively and equally assigned to five groups randomly of different ESTT as 100, 110, 120, 130 and 140 HU. Noise, signal-to-noise ratios （SNR）, contrast-to-noise ratios （CNR）, enhancement extent （EE） of coronary artery and myocardium, iodine concentration, beam hardening （BH） objective value and subjective rating of myocardium and EE of left ventricle （LV） were measured and compared between different group;and noise, SNR, CNR, EE of coronary artery and myocardium, iodine concentration and BH objective value of myocardium obey normal distribution and equal variance, so they were expressed as mean±standard deviation and compared with variance analysis of multiple independent samples, and pairwise comparison were done with SNK test. Myocardial BH subjective rating was ranked data, and was expressed as [median （P25, P75）], and compared with Kruskal-Wallis test, and pairwise comparison were done with Nemenyi test.ResultsPost contrast CT value of LAD, post contrast CT value and EE of LV chamber were different with different ESTT （F=3.471, 3.795, 3.132,and all P〈0.05） Post contrast CT value of LAD was lower with 130 HU [（355.16±59.11） HU than ESTT of 100 HU [（404.9±49.0） HU]. Myocardial BH value and subjective score were different with different ESTT （F=6.118, H=13.702, P all〈0.05）. Myocardial BH value was lower with ESTT of 130, 140 HU [（8.8±12.4）, （5.4±17.1） HU] than 100, 110 HU [（24.2±17.7）, （22.1±11.6） HU]. Myocardial BH subjective score was lower with ESTT of 130 HU [1.5（1.0, 2.0）] than 110 HU [3.0（2.0, 3.0）]. Post contrast CT value and EE of LV myocardium, noise, SNR and CNR of LAD and LV myocardium, EE of LAD were not different between group of diff

关 键 词：冠状血管 心肌 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学]