宽容度在前瞻性心电门控冠状动脉CTA中的应用价值  

The Value of Phase Tolerance in Prospective Electrocardiogram-Gated Coronary CTA

作　　者：赵婷婷[1] 刘文骏 张蕴[1] 

机构地区：[1]西安交通大学医学院第一附属医院影像科,西安710061 [2]西安交通大学医学院部公共卫生学院流行病与卫生统计学教研室

出　　处：《临床放射学杂志》2018年第2期322-326,共5页Journal of Clinical Radiology

摘　　要：目的探讨宽容度在前瞻性心电门控冠状动脉CT血管成像（CCTA）中的应用价值。方法纳入心率、心律符合条件的行前瞻性心电门控CCTA患者190例,根据宽容度分为1、2、3组,1组宽容度为0,57例;2组宽容度为3%,68例;3组宽容度为5%,65例。记录并计算有效辐射剂量（ED）,评价图像质量。各组间ED、对比噪声比（CNR）、信噪比（SNR）进行比较。扫描参数：体质指数（BMI）30 kg/m2 75例,管电压140 kV;均启动自动管电流控制技术。结果 ED值：1组100 kV、120 kV、140 kV时分别为（3.82±0.24）mSv、（5.37±1.18）mSv、（6.70±0.59）mSv,2组100 kV、120 kV、140kV时分别为（4.77±0.66）mSv、（6.49±0.58）mSv、（9.01±1.06）mSv,3组100 kV、120 kV、140 kV时分别为（5.44±0.59）mSv、（7.51±1.17）mSv、（9.63±1.53）mSv,组间同一管电压ED值具有统计学差异（P值均=0.000,P〈0.05）。1、2、3组CNR均值分别为（9.36±3.04）、（7.86±2.74）、（10.24±4.20）,无统计学差异（F=2.66,P=0.07）;1、2、3组右冠状动脉第1段SNR均值（12.09±4.30）、（11.28±5.33）、（11.91±3.44）,无统计学差异（F=0.18,P=0.83）,左冠状动脉主干（第5段）SNR均值（11.74±4.57）、（10.54±4.64）、（13.36±4.03）,无统计学差异（F=1.96,P=0.15）。结论前瞻性心电门控CCTA同一管电压宽容度0、3%、5%的ED值均依次增高;心率较低、心律稳定者主观图像质量评价优良,不同宽容度不同管电压的CNR、SNR无明显差异。Objective To explore the application value of phase tolerance in prospective electrocardiogram（ ECG）-gated coronary computed tomography angiography（ CCTA）. Methods According to heart rate and cardiac rhythm,190 cases underwent prospective ECG-gated CCTA. All the cases were divided into three groups according to the degree of phase tolerance. The group 1（ G1）,group 2（ G2）,and group 3（ G3） of the degree of phase tolerance were 0,3%,5%,and the corresponding 57,68,and 65 cases. The effective doses（ ED） were calculated. Then the image quality was evaluated,which included contrast-to-noiseratio（ CNR） and signal-to-noise ratio（ SNR）. ED and the image quality were compared among the groups. The scanning parameters were： BMI 22 kg/m^2,100 kV,61 cases; BMI 22 ~ 30 kg/m^2,120 kV,54 cases; BMI 30 kg/m^2,140 kV,75 cases. Automatic tube current modulation was applied for all cases. Results ED values were compared among the groups. When the tube voltage was selected 100 kV,120 kV,and 140 kV,the ED of G1,G2,and G3 were [（ 3. 82 ± 0. 24） mSv,（ 5. 37 ± 1. 18） mSv,and（ 6. 70 ± 0. 59） mSv],[（ 4. 77 ± 0. 66） mSv,（ 6. 49 ± 0. 58）mSv,and（ 9. 01 ± 1. 06） mSv],and [（ 5. 44 ± 0. 59） mSv,（ 7. 51 ± 1. 17） mSv,and（ 9. 63 ± 1. 53） mSv],respectively.The ED value of the same tube voltage between the groups was statistically significant（ P = 0. 000,P〈0. 05）. The CNR were compared among the groups,and no significant difference was found（ F = 2. 66,P = 0. 07）. The mean CNR of groups were（ 9. 36 ± 3. 04,G1）,（ 7. 86 ± 2. 74,G2）,and（ 10. 24 ± 4. 20,G3）,respectively. The SNR were compared among the groups. The SNR values of the first segment coronary artery of G1,G2,and G3,were（ 12. 09 ± 4. 30）,（ 11. 28 ± 5. 33）,and（ 11. 91 ± 3. 44）,respectively. There was no significant difference（ F = 0. 18,P = 0. 83）. The SNR values of the fifth segment coronary artery of G1,G2,and G3,were（ 11. 74 ± 4. 57）,（ 10. 54 ± 4. 64）,and（ 1

关 键 词：冠状动脉 计算机体层成像 血管造影 宽容度 有效剂量 图像质量 

分 类 号：R816.2[医药卫生—放射医学]