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作 者:崔晓明 叶道斌[1] 张如意 李涛[1] CUI Xiao-ming;YeDao-bin;ZHANG Ru-yi;LI Tao(Medical Center,General Hospital of Armed Police Force,Beijing 100039,China)
机构地区:[1]中国人民武装警察部队总医院健康医学中心CT室,北京100039
出 处:《中国急救复苏与灾害医学杂志》2018年第8期736-741,共6页China Journal of Emergency Resuscitation and Disaster Medicine
基 金:武警部队课题资助课题(WZ2011047)
摘 要:目的使用高分辨率宝石CT(aa high—definition Gemstone,MDCT),使用4种不同的重建方法,评价在人体内的冠状动脉支架和支架内径。方法对连续的26名支架植入术后的患者,使用高分辨cT扫描仪行冠状动脉CT检查,使用4种不同的卷积核,对图像进行重建,观察支架的特点及支架内腔。重建方法有四种(HD stand;HD detail;HD stand plus;HD detail plus),对植入支架的冠状动脉进行后重建。评价植入支架的冠状动脉的影像质量。测量图像的噪声与支架内腔直径。分析测量的支架内径和支架的真实直径之间的关系,并分析测量的支架内径与支架类型之间的相关性。对使用前瞻性心电门控扫描与回顾性心电门控扫描的辐射剂量进行比较。结果使用HD detail重建方法,对支架显示得到优质图像的百分比最高;而且腔内直径(lumen diameter,ISD)与支架直径(stent diameter,TSD)的比例最高(68±10.3%),但是图像的噪声增大了。ISD与支架真实直径测量之间的皮尔森相关系数为0.83。ISD测量与支架类型之间的相关系数为0.48。采用前瞻性心电门控技术的辐射剂量(2.28±0.74msv)比回顾性心电门控技术的辐射剂量(11.34±2.45 msv)显著降低。结论与传统的重建算法比较,高分辨率MDCT成像技术加上精细的重建算法能清楚地显示支架内特点,并且对支架内腔直径测量准确率高。高分辨的扫描模式加上HD detail的重建方法是成像冠状动脉支架、观察冠状动脉内腔最适合的程序。Abstract: Objective To investigat what is the optimal reconstruction approach of coronary stents in high-definition CT. Methods Twenty-six consecutive stented patients underwent multi-detectorcomputed tomography angiography (MDCTA) of the coronary artery with high resolution CT scanner. Four different convolution kernels (HD stand, HD detail, HD stand plus, and HD detail plus) were applied to reconstruct the images of the stented coronary artery. ANOVA was used to analyze the differences in the inner stent diameter (ISD) and image noise Radiation dose was compared between prospective and retrospective ECG-gated technique. Results The rate of high quality images reconstructed by HD detail was the highest. The rate of high quality images reconstructed by HD detail plus was signifiantly higher than that by the cenventional HD stand. The HD detail reconstruction was superior to the 3 other methods in diameter measurement, however, there was no significant differences in the quality of diameter measurement among these kernels (all P〉 0.05).The noise value obtained by HD detail plus reonstruction was significantly higher than those by HD stand and HD stand plus reconstructions (both P〈0.05). The Pearson correlation coefficient between the measurement of ISD and the stent true diameter was 0.83, and the Spearman correlation coefficient between the measurement of ISD and the stent type was 0.48. The radiation dose was significantly lower using prospective (2.28 ± 0.74 mSv) than retrospective ECG-gated technique (11.34 ± 2.45 mSv). Conclusion High-definition MDCT imaging technology with dedicated reconstruction method has shown desirable results regarding stent lumen visualization. The stent lumen visibility also depends on the individual stent diameter and material.Non-helical prospective ECG-triggering scan imaging coronary stent can markedly reduce the radiation dose.
关 键 词:冠状动脉支架 计算机断层扫描 高分辨率 CT血管造影.
分 类 号:R542.1[医药卫生—心血管疾病]
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