256排Revolution CT对不控制心率患者行胸痛三联扫描的可行性研究  

A Feasibility Study of the Triple Rule out CTA by using the 256-Row Revolution CT Without Controlling the Heart Rate of the Patients

作　　者：徐秋贞[1] 郭文文 王威 邵海磊 吴晓璐 陈文达 XU Qiuzhen;GUO Wenwen;WANG Wei(Department of Radiology,Southeast University Medical College,Affiliated Zhongda Hospital of Southeast University,Nanjing 210009,P.R.China)

机构地区：[1]东南大学医学院,东南大学附属中大医院放射科,南京210009

出　　处：《临床放射学杂志》2020年第2期398-402,共5页Journal of Clinical Radiology

摘　　要：目的探讨使用256排Revolution CT宽体探测器对不控制心率患者行胸痛三联扫描的可行性。方法搜集2016年8月至2018年10月就诊于本院的75例胸痛患者。根据心率分为A(心率≤70次/分)、B(70次/分<心率<85次/分)、C(心率≥85次/分)三组,每组25例。使用256排Revolution CT,分别对三组患者进行三联扫描,测量各组图像的CT值、噪声,计算图像的信噪比及对比噪声比,记录剂量长度乘积,计算辐射剂量。以胸主动脉及肺动脉的CT值>200 HU作为满足诊断条件的标准,由2名放射科医师对冠状动脉图像质量进行主观评价。连续变量采用单因素方差分析或非参数检验,等级资料比较采用Kruslal-wallis H检验,P<0.05表示差异具有统计学意义。结果三组患者的性别、年龄、体重指数无明显差异;三组患者的肺动脉、胸主动脉及右冠状动脉的信噪比分别为20.0(6.0)、19.2±3.0、19.3±5.2,14.7(4.1)、14.3±3.8、13.4±6.1,13.5(5.5)、13.5±3.1、13.6±3.5(P=0.194,0.148,0.941),对比噪声比分别为24.5(16.0)、23.7±5.6、22.0±9.5,17.3(5.1)、16.5±6.7、13.2±9.6,19.9±5.1、18.3(4.1)、18.9(5.7)(P=0.295,0.053,0.622),无明显差异;三组患者的主观评分无明显差异(1.67±0.70、1.78±0.69、1.72±0.66,P=0.105)。结论256排Revolution CT对不控制心率患者行胸痛三联CTA具有可行性。Objective The purpose of this work is to investigate the feasibility of triple rule out CTA by using the 256-row Revolution CT without controlling the heart rate of the patients.Methods From August 2016 to October 2018,we collected a total of 75 patients.They were divided into three groups equally according to the heart rate:A(heart rate≤70 bmp),B(70 bpm<heart rate<85 bpm)and C(heart rate≥85 bpm).Triple rule out CTA of all the patients was carried out by using the 256-row Revolution CT.The CT values and noise were measured to calculate the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR).The dose-length product generated by the machine was recorded to calculate the effective radiation dose.To meet the diagnostic criteria,the CT values of thoracic aorta and pulmonary artery were required to be more than 200 HU.The subjective evaluation of coronary image quality was performed by two radiologists.Analysis ofvariance test or nonparametric test was used.Continuous variables and Kruslal-wallis H test was used for comparison of grade data.P<0.05 indicated that the difference was statistically significant.Results There were no significant difference in gender,age,and body mass index(BMI)between the three groups of patients.The signal-to-noise ratio SNR,20.0(6.0)vs 19.2±3.0 vs 19.3±5.2,14.7(4.1)vs 14.3±3.8 vs 13.4(6.1),13.5(5.5)vs 13.5±3.1 vs 13.6±3.5(P=0.194,0.148,0.941)and contrast noise ratio CNR,24.5(16.0)vs 23.7±5.6 vs 22.0±9.5,17.3(5.1)vs 16.5±6.7 vs 13.2±9.6,19.9±5.1 vs 18.3(4.1)vs 18.9(5.7)(P=0.295,0.053,0.622)of pulmonary artery and thoracic aorta were not significantly different,as well as the subjective scores of coronary arteries(1.67±0.70 vs 1.78±0.69 vs1.72±0.66,P=0.105).Conclusion Triple rule out CTA was feasibly performed in patients,using the 256-row Revolution CT,without controlling the heart rate.

关 键 词：胸痛 心率 Revolution CT 对比剂剂量 

分 类 号：R816.2[医药卫生—放射医学]