基于80 kV冠状动脉CTA前瞻性单时相扫描在体检者中的应用价值  

Application value of prospective single phase scan based on 80 kV coronary CTA in physical examination

作　　者：汤化民[1] 苟杰[1] 银文杰[1] 林伟[1] 贺倩[1] 张波莉[1] 杨帆[1] TANG Huamin;GOU Jie;YIN Wenjie;LIN Wei;HE Qian;ZHANG Boli;YANG Fan(Department of Radiology,Chengdu First People’s Hospital,Chengdu 610041,China)

机构地区：[1]四川省成都市第一人民医院放射科,四川成都610041

出　　处：《中国中西医结合影像学杂志》2020年第6期639-643,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：四川省卫生计生委科技项目(18pj139)。

摘　　要：目的:探讨以80 kV低管电压为基础,冠状动脉(简称冠脉)CTA单时相扫描在体检者中的应用价值。方法:招募45例符合纳入标准的自愿者随机分为传统回顾性多时相扫描组(传统组)23例及前瞻性单时相扫描组(前瞻组)22例,采用固定对比剂用量及流率方案,通过CT值及CNR比较客观图像质量;基于Likert分级评分法比较主观图像质量,配对分析2组最终诊断结果的人数构成比差异及有效辐射剂量。结果:前瞻组1例扫描失败。除前降支远段2组CT值差异无统计学意义(P>0.05)外,前瞻组冠脉各段及左心室强化程度均高于传统组(均P<0.05)。前瞻组右冠脉近段及左心室的CNR优于传统组(均P<0.05),其余各部位差异无统计学意义。2组整体主观图像质量差异无统计学意义(P>0.05)。2组对冠脉常见疾病诊断结果敏感度相似,同时前瞻组辐射剂量降低了约80.0%。结论:前瞻性单时相扫描虽存在扫描失败风险,但对以筛查为目的、对结果特异度要求相对较低的体检人群,在保证设备可靠性前提下应用,可提高冠状动脉粥样硬化性心脏病早期检出率,为临床预防提供有力支撑。Objective:To explore the application value of single phase coronary CTA in physical examination based on 80 kV low tube voltage.Methods:45 volunteers were randomly divided into two groups,the traditional retrospective multi-phase scanning group(22 cases)and the prospective single-phase scanning group(23 cases).The scheme of fixed contrast agent dosage and flow rate was adopted.Objective image quality was compared by CT value and CNR,subjective image quality was compared by Likert grading score method,and the difference of population composition ratio and effective radiation dose between the two groups were analyzed.Results:Scan failure occurred in 1 case in the prospective group.The CT values of each segment of coronary artery except distal segment of anterior descending branch and the CT value of left ventricle in the prospective group were higher than those in the traditional group(all P<0.05).The CNR of the proximal right coronary artery and the left ventricle in the prospective group were better than those of the traditional group(both P<0.05),and the differences of other parts were not statistically significant.There was no significant difference in image quality between the two groups.Prospective single phase scanning reduced radiation dose by about 80.0%.Conclusions:Although there is a risk of scan failure in prospective single phase scanning,for the physical examination population whose results are not specific for the purpose of screening,on the premise of ensuring the reliability of equipment,we think it can be applied to the physical examination population to improve the early detection rate of coronary heart disease and provide strong support for clinical prevention.

关 键 词：冠状血管造影术 体层摄影术 X线计算机 辐射剂量 

分 类 号：R541.4[医药卫生—心血管疾病]