高心率患者冠状动脉CTA收缩期绝对时相重组的优化  

Optimization of Absolute Phasic Systolic Acquisition in Coronary CT Angiography in Patients with High Heart Rate

作　　者：阮席武[1] 蒋佳珅 邵君 詹蕊 黄胜[1] 严松强[1] 祁荣兴[1] RUAN Xiwu;JIANG Jiashen;SHAO Jun(Department of Radiology,the Second Affiliated Hospital of Nantong University,Nantong 226001,P.R.China)

机构地区：[1]南通大学第二附属医院影像科,226001

出　　处：《临床放射学杂志》2022年第5期866-871,共6页Journal of Clinical Radiology

基　　金：2021年度江苏省医学会科研专项项目(编号:SYH-3201150-0010);2021年度南通市社会民生科技项目(编号:JC2021195);南通市临床医学中心项目(编号:HS2019002)。

摘　　要：目的比较高心率(HR)患者优化的收缩期绝对时相、收缩期相对时相和舒张期相对时相的冠状动脉CT血管造影(CCTA)图像质量,以确定最佳采集期相。方法搜集2020年1月至2021年5月Force CT扫描的HR≥80次/min的患者109例,其中HR80~100次/min 85例(A组),HR≥100次/min 24例(B组)。预定义收缩期绝对时相重组范围为R波后180~400 ms,分成180~240 ms、260~320 ms、340~400 ms三组,另外选取成像系统自动选择的最佳收缩期相对时相和最佳舒张期相对时相图像,评估各组各期相右冠状动脉(RCA)、锐缘支(AM)、后降支(PDA)、左主干(LM)、左前降(LAD)、对角支(D1)、左旋支(LCX)、钝缘支(OM)的图像优秀率、可诊断率和主观评分。结果A组的绝对时相最佳收缩期位于260~320 ms,RCA、AM、PDA、LM、LAD、D1、LCX、OM的图像优秀率分别达30.59%、27.06%、58.82%、85.88%、77.65%、47.06%、62.35%、38.82%,优于其他两组(P<0.05);B组的绝对时相最佳收缩期位于180~240 ms,各支血管图像优秀率分别达37.5%、37.5%、66.67%、91.67%、87.5%、62.5%、70.83%、50.0%,图像优秀率明显高于其他两组(P<0.05)。A、B组优化的收缩期绝对时相各支血管评分平均分数[1.5(1.3,1.8)、1.4(1.1,1.8)]明显优于收缩期相对时相血管评分[2(1.9,2.3)、2.8(2.7,3)]和舒张期相对时相血管评分[1.9(1.8,2.3)、2.9(2.8,3.1)](P均<0.001)。结论高HR患者收缩期绝对时相重组能够取得较好的诊断图像质量,合适的期相范围为180~320 ms,明显优于收缩期相对时相和舒张期相对时相重组图像质量。Objective To investigate the optimal acquisition phase through comparing image quality of absolute systolic phase reconstruction,relative systolic phase reconstruction,and relative diastolic phase reconstruction in patients with high heart rate(HR)undergoing coronary CT angiography(CCTA).Methods A total of 109 patients with high heart rate(≥80 beats/min)from January 2020 to May 2021 were consecutively enrolled in the study,and were divided into group A(80≤HR<100 beats/min,n=85)and group B(HR≥100 beats/min,n=24).The systolic reconstruction time was preset to 180-400 ms after R wave,and was divided into 3 phases(180~240 ms,260~320 ms,340~400 ms).The optimal systolic and diastolic relative phase images automatically selected by imaging system were obtained.Evaluate the excellent rate,diagnosable rate,and visual score of right coronary artery(RCA),acute marginal artery(AM),posterior descending artery(PDA),left main artery(LM),left anterior descending artery(LAD),first diagonal branch(D1),left circumflex artery(LCX)and obtuse marginal branch(OM)among 3 absolute phases in these two groups,and then obtain the optimal reconstruction phase.Compare image quality of optimized absolute phase systolic reconstruction,relative phase systolic reconstruction,and relative phase diastolic reconstruction.Results The optimal phase of group A was within the time of 260-320 ms,and the excellent rates of RCA,AM,PDA,LM,LAD,D1,LCX,OM were 30.59%,27.06%,58.82%,85.88%,77.65%,47.06%,62.35%,38.82%respectively,which were significantly higher than those of the two other phases(P<0.05,respectively).The optimal phase of group B was within 180-240 ms,and the excellent rates of the branches were 37.5%,37.5%,66.67%,91.67%,87.5%,62.5%,70.83%,50%respectively,which were significantly higher than those of the two other phases(P<0.05,respectively).The image quality of optimized absolute phase systolic reconstruction[mean scoring 1.5(1.3,1.8)、1.4(1.1,1.8)]was significantly better than that of relative systolic phase reconstruction and relative dia

关 键 词：高心率 收缩期 绝对时相 冠状动脉CTA 体层摄影术 X线计算机 

分 类 号：R816.2[医药卫生—放射医学]