急性缺血性脑卒中双源CT大螺距非门控心脑联扫的图像质量优化研究  

Optimization of Image Quality in High-Pitch Non-Gated Heart-Brain CTA with Dual-Source CT in Acute Ischemic Stroke

作　　者：刘佳宾[1] 王臣[1] 祝小莲[1] 李岩[1] 沈翀[1] 禹烜[1] 杜祥颖[1,2] 李坤成 卢洁[1,2] LIU Jiabin;WANG Chen;ZHU Xiaolian;LI Yan;SHEN Chong;YU Xuan;DU Xiangying;LI Kunchen;LU Jie(Department of Radiology and Nuclear Medicine,Xuanwu Hospital,Capital Medical University,Beijing 100053;Beijing Key Laboratory of MRI and Brain Informatics,Beijing 100053)

机构地区：[1]首都医科大学宣武医院放射与核医学科,北京100053 [2]磁共振成像脑信息学北京市重点实验室,北京100053

出　　处：《中国医疗设备》2022年第8期164-167,182,共5页China Medical Devices

基　　金：北京市自然科学基金资助项目(Z190014)。

摘　　要：目的评估双源CT不同螺距自由呼吸非门控条件下心脑联合扫描在急性缺血性卒中患者应用中的图像质量差异,以优化扫描方案。方法选择2018年1—12月在我院就诊拟诊急性缺血性脑卒中并行急诊CT灌注成像(CT Perfusion Imaging,CTP)联合头颈部血管CT造影(CT Angiography,CTA)检查患者作为实验组,并按照扫描时螺距不同随机分为A组(螺距2.0)和B组(螺距3.2)。以2017年11月至2018年4月于门诊常规预约行心脑联合CTA检查患者作为对照组(C组)。采用西门子公司第三代双源CT Force扫描,比较3组图像质量。结果A组共纳入患者24例,B组共纳入患者22例,C组共纳入患者26例。3组患者性别、年龄、体质指数、心率比较无统计学差异(P>0.05);3组图像客观评价指标比较无统计学差异(P>0.05);3组主观评价中运动伪影有统计学差异(P<0.05),其中A组图像质量最差,B组与C组无统计学差异(P>0.05)。结论在使用3.2螺距进行自由呼吸非门控心脑联扫时,可在不增加患者辐射剂量和不影响头颈CTA质量的前提下,提供心脏结构解剖信息,为心源性梗死的鉴别提供影像学解决方案。Objective To evaluate the image quality differences of dual source CT at different pitch in free breathing non-gated mode for combined cardio-cerebral scanning in patients with acute ischemic stroke,and optimize the scanning scheme.Methods Patients with suspected acute ischemic stroke with emergency CT perfusion imaging(CTP)combined with head and neck CT angiography(CTA)in our hospital from January to December 2018 were selected,and the experimental group was randomly divided into group A(pitch 2.0)and group B(pitch 3.2)according to the different pitch at the time of scanning.Patients with routine outpatient appointments for combined cardiac and cerebral CTA examinations from November 2017 to April 2018 were selected as control group(group C).The scanning equipment used was third-generation dual-source CT force from Siemens.The image quality among three groups were compared.Results A total of 24 patients were included in group A,22 patients in group B and 26 patients in group C respectively.There was no significant difference in gender,age,body mass index and heart rate among the three groups(P>0.05).There was significant difference in the subjective evaluation of motion artifacts among the three groups(P<0.05),among which group A had the worst image quality,and there was no significant difference between group B and group C(P>0.05).Conclusion Free breathing non-gated cardio-cerebral cascade using 3.2 pitch can provide anatomical information of cardiac structures without increasing the radiation dose to the patient and without affecting the quality of head and neck CTA,which can provide an imaging solution for the identification of cardiogenic infarction.

关 键 词：双源CT 多排螺旋CT CTA 急性缺血性脑卒中 

分 类 号：R816.2[医药卫生—放射医学]