ForceCT在不同心率患者CT冠状动脉成像检查中的应用效果观察  

Observation on the application effect of Force CT in CT coronary angiography for patients with different heart rate

作　　者：张杨[1] 蒋涛[1] ZHANG Yang;JIANG Tao(Department of Radiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《实用放射学杂志》2020年第2期300-303,316,共5页Journal of Practical Radiology

摘　　要：目的观察Force CT在不同心率(HR)患者CT冠状动脉成像(CTCA)检查中的应用效果.方法回顾性分析502例疑似冠心病患者临床资料,均行CTCA检查,依据HR不同分为A组(HR≤75次/min,n=144)、B组(HR 76~95次/min,n=207)、C组(HR≥96次/min,n=151),依据HR不同采用Auto-gating功能自动设定不同扫描时相,对图像进行R-R间期重建,分析3组图像质量、冠状动脉节段可评价率、辐射剂量[容积剂量指数(CTDIvol)、有效剂量(ED)]、CTCA诊断冠心病的效能.结果A组、B组、C组图像质量评分有下降趋势,尤其在左回旋支(LCX)上图像质量评分下降最明显(F=316.691,P<0.001),左前降支(LAD)、左主干动脉(LMA)次之,右冠状动脉(RCA)影响最小;3组冠状动脉节段可评价率比较差异无统计学意义(P>0.05);3组CTDIvol、ED有统计学差异(F=289.971、342.800,P<0.001),C组CTDIvol、ED低于A组、B组,A组、B组上述指标差异也有统计学意义(P<0.05);不同HR组诊断冠状动脉狭窄的效能比较差异无统计学意义(P>0.05),CTCA诊断冠心病(狭窄程度≥50%)的灵敏度、特异度、准确度、Kappa值分别为82.86%、94.23%、91.37%、0.771.结论Force CT可用于不控制心率情况下不同HR患者的CTCA检查,随HR升高图像质量下降(以LCX更明显),但不同HR下CTCA诊断冠状动脉狭窄的效能无差异,而辐射剂量有下降趋势.Objective To observe the application effect of Force CT in CT coronary angiography(CTCA)for patients with different heart rate(HR).Methods The clinical data of 502 patients with suspected coronary heart disease who were admitted to the hospital were analyzed retrospectively.All patients underwent CTCA examination.According to different HR,they were divided into group A(HR 75 beats per minute,n=144),group B(HR 76-95 beats per minute,n=207)and group C(HR≥96 beats per minute,n=151).Different scanning phases were automatically set according to different HR by Auto-gating.The R-R interval reconstruction of images was performed.The images quality,evaluable rate of coronary artery segments,radiation dose[CT dose index volume(CTDIvol),effective dose(ED)]and the efficiency of CTCA for the diagnosis of coronary heart disease in the three groups were analyzed.Results The image quality scores in the three groups showed a downward trend.Besides,the image quality scores of left circumflex(LCX)decreased most obviously(F=316.691,P<0.001),followed by left anterior deseeding(LAD)and left main artery(LMA),and the influence on right coronary artery(RCA)was the least.There was no significant difference in the evaluable rate of coronary artery segments among the three groups(P>0.05).There were significant differences in CTDIvol and ED among the three groups(F=289.971,342.800,P<0.001).The CTDIvol and ED in group C were lower than those in group A and group B.Thc differences of the above indexes between group A and group B were statistically significant(P<0.05).There was no significant difference in the diagnosis efficiency of coronary artery stenosis among different HR groups(P>0.05).The sensitivity,specificity,accuracy and Kappa value of CTCA for the diagnosis of coronary heart disease(stenosis degree≥50%)were 82.86%,94.23%,91.37% and 0.771,respectively.Conclusion Force CT can be used on CTCA examination for patients with different HR without controlling heart rate.The image quality decreases with the increase of HR which is more

关 键 词：冠心病 心率 CT冠状动脉成像 

分 类 号：R541.4[医药卫生—心血管疾病] R814.42[医药卫生—内科学]