超高速宽体探测器CT单心动周期冠状动脉成像:快速与慢速心率的对比  

Coronary CT angiography in single cardiac cycle using ultra-high-speed and wide detector CT:a comparative study of high and low heart rate

作　　者：刘军波[1] 张晓浩[1] 管延芳[1] 周伟[1] 范丽娟[1] LIU Jun-bo;ZHANG Xiao-hao;FAN Li-juan(Department of Radiology,Tianjin Economic-Technological Development Area(TEDA)International Cardiovascular Hospital,Tianjin 300457,China)

机构地区：[1]泰达国际心血管病医院放射科

出　　处：《放射学实践》2019年第12期1322-1326,共5页Radiologic Practice

基　　金：天津市滨海新区卫生局科技项目(2013BWKZ008)

摘　　要：目的:探讨在快速心率(≥100次/分)患者中超高速宽体探测器CT单心动周期冠状动脉成像质量和最佳期相。方法:回顾性分析临床疑似冠状动脉病变而行单心动周期冠状动脉宽体探测器CT扫描的300例患者的病例资料,其中快速心率组(≥100次/分)150例,对照组(≤65次/分)150例。测量两组MSCT图像上主动脉根部、LAD和RCA中段的CT值,计算前降支中段的信噪比(SNR)和对比噪声比(CNR),分析冠状动脉可诊断率和图像质量优等率,计算两组扫描的有效辐射剂量(ED),比较两组间各项测量指标间的差异。结果:快速心率组最佳期相为(49.1%±6.7%)R-R间期,对照组为(72.1%±11.8%)R-R间期。两组图像质量客观指标(主动脉根部CT值、LAD和RCA中段CT值、前降支中段的SNR和CNR)间的差异均无统计学意义(P>0.05)。两组图像上LAD、LCX和RCA可诊断率的差异均无统计学意义(P>0.05);但图像优等率的差异均有统计学意义(P<0.05),快速心率组均低于对照组(72.6%vs.83.2%,60.1%vs.84.5%,74.6%vs.90.6%)。两组间扫描中辐射剂量的差异有统计学意义(P<0.05),快速心率组低于对照组。结论:超高速宽体探测器CT单心动周期冠状动脉成像可作为快速心率患者的常规检查方法,但成像质量的优等率低于慢心率的患者。Objective:To investigate the imaging quality and optimal phase of coronary CT angiography(CCTA)in single heart cycle with high heart rate(heart rate≥100bpm)using ultra-high-speed and wide detector CT.Methods:300 cases with suspected coronary artery disease were included retrospectively,including 150 cases as high heart rate group(≥100bpm)and 150 cases as control group(≤65bpm).All the subjects underwent CCTA examination within single cardiac cycle using ultra-high-speed and wide detector CT.Parameters including CT values of the aorta root and middle segment of left anterior descending artery(LAD)and right coronary artery(RCA),the signal to noise ratio(SNR)and the contrast noise ratio(CNR)of the images,the diagnostic rate and the excellent rate of coronary artery on CT images,and effective dose(ED)were measured and calculated,and the differences of such indexes between the two groups were compared.Results:The optimal phase of the high heart rate group was at the end of the systolic period(49.1%±6.7%R-R interval),and the optimal phase of the control group was in the middle and late systolic period(72.1%±11.8%R-R interval).There were no significant differences(all P>0.05)between the two groups in objective indexes of image quality(CT values of aortic root,middle segment of LAD and RCA,SNR and CNR).There was no significant difference in the diagnostic rate of LAD,LCX and RCA(all P>0.05).The excellent rates of LAD,LCX and RCA images in the high heart rate group and the control group were statistically different(all P<0.05),and the high heart rate group was lower than that of the control group(72.6%vs.83.2%,60.1%vs.84.5%,74.6%vs.90.6%).The radiation dose of the high heart rate group and the control group was statistically significant(P<0.05),and the high heart rate group was lower than that of the control group.Conclusion:Single cardiac cycle scan of high heart rate with high heart rate using ultra-high-speed and wide detector CT can be used as a routine examination of coronary artery disease,but the rate of exc

关 键 词：体层摄影术 X线计算机 冠状动脉 血管成像 心率 辐射剂量 运动伪影 

分 类 号：R814.42[医药卫生—影像医学与核医学] R543.3[医药卫生—放射医学]