双源CT前瞻性绝对时相单收缩期采集在高心率患者中的应用  

Prospective sequence acquisition in systolic phases using absolute delay time for dual-source CT in patients with high heart rate

作　　者：祁荣兴 阮席武[2] 黄胜[2] 王天乐[2] 郑扣龙[3] 张树清[3] 胡春洪[1] QI Rongxing;RUAN Xiwu;HUANG Sheng;WANG Tianle;ZHENG Koulong;ZHANG Shuqing;HU Chunhong(Department of Radiology,the First Affiliated Hospital of Soochaw University,Suzhou,Jiangsu Province 215006;Department of Radiology,the Second Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226001,China;Department of Cardiology,the Second Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226001,China)

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006 [2]南通大学第二附属医院影像科,江苏南通226001 [3]南通大学第二附属医院心内科,江苏南通226001

出　　处：《实用放射学杂志》2021年第6期931-935,共5页Journal of Practical Radiology

基　　金：南通市科技计划项目(GJZ17015)。

摘　　要：目的利用双源CT前瞻性绝对时相采集高心率(HR)患者(平均HR≥90次/min)的收缩期相,评估其诊断的准确性、图像质量和辐射剂量.方法选取平均HR≥90次/min行双源冠状动脉CT血管成像(CCTA)检查患者102例,采用前瞻性绝对时相采集患者的收缩期(预设定R波后200~400 ms),其中90次/min≤HR<110次/min 79例,HR≥110次/min 23例.CCTA诊断结果以侵入冠状动脉造影(ICA)作为金标准进行对照,并评估图像质量和辐射剂量.结果1530个冠状动脉节段中有77(5%)个节段不能评估.当不能评估节段归为狭窄,基于段的诊断准确性为90.1%,基于患者的诊断准确性为88.2%;当不能评估的节段归为误诊,基于段的诊断准确性为88.9%,基于患者的诊断准确性为86.3%.单CCTA的平均有效剂量(ED)为(0.74±0.25)mSv.结论前瞻性绝对时相单收缩期采集能完成高HR甚至心动过速患者的检查,能够取得很好的诊断图像质量,降低辐射剂量.Objective To evaluate the diagnostic accuracy,image quality and radiation dose with applying prospective sequence acquisition in systolic phases using absolute delay time for dual-source CT in patients with high heart rate(HR)(mean HR≥90 beats per minute).Methods The subjects were 102 patients with mean HR≥90 beats per minute who underwent prospective sequence scan in systolic phases using absolute delay time(pre-specified 200-400 ms after the R-wave)for dual-source coronary CT angiography(CCTA).There were 79 patients with 90 beats per minute≤HR<110 beats per minute and 23 patients with HR≥11O beats per minute.The CCTA findings were compared against invasive coronary angiography(ICA)whose results as the gold standard.Objective image quality,subjective image quality and radiation dose of CCTA were measured and compared with those of ICA.Results 77(5%)of the 1530 segments could not be evaluated in all the patients.When non-evaluable segments were classified as stenosis,the diagnostic accuracy was 90.1%based on a per-segment and 88.2%based on a per-patient in all the patients;The diagnostic accuracy was 88.9%based on a per-segment and 86.3%based on a per-patient in all the patients,with non-evaluable segment considered to be an incorrect diagnosis.For CCTA alone,the mean effective dose(ED)was(0.74d=0.25)mSv in all the patients.Conclusion Prospective sequence acquisition in systolic phases using absolute delay time can achieve diagnostic image quality in patients with HR≥90 beats per minute(even tachycardia),meanwhile greatly reducing the radiation dose.

关 键 词：计算机体层成像 血管造影术 收缩期相 心率 

分 类 号：R814.42[医药卫生—影像医学与核医学] R814.43[医药卫生—放射医学]