对比呼气末屏气与吸气末屏气在冠状动脉CT血管成像中的应用  

Comparison of the Application of End Expiratory Breath Holding and End Inspiratory Breath Holding in Coronary CT Angiography

作　　者：曹治婷[1] 曾靖童 廖玉荣[1] 王甜[1] 廖立 霍鑫 CAO Zhiting;ZENG Jingtong;LIAO Yurong;WANG Tian;LIAO Li;HUO Xin(Department of Radiology,Liuzhou People's Hospital,Liuzhou 545006,China;Department of Angiological Surgery,Liuzhou People's Hospital,Liuzhou 545006,China;Department of Clinical Medicine,Clinical Medical Cllege of Tianjin Medical University)

机构地区：[1]广西柳州市人民医院放射科,柳州545006 [2]广西柳州市人民医院血管外科,柳州545006 [3]天津医科大学临床医学院临床医学系

出　　处：《中国医学计算机成像杂志》2022年第4期361-365,共5页Chinese Computed Medical Imaging

基　　金：广西壮族自治区卫计委自筹经费科研课题(Z20210006,Z20200148);柳州市人民医院引进高层次人才科研启动基金项目(LRYGCC202101)。

摘　　要：目的:对比研究呼气末屏气与吸气末屏气在冠状动脉CT血管成像(CCTA)中的应用,探讨呼气末屏气在CCTA的应用价值。方法:纳入100例CCTA怀疑冠状动脉狭窄并行冠状动脉造影(CGA)的患者,以单双的顺序分组,单数为常规深吸气末屏气组(A组)50例、双数为深呼气末屏气组(B组)50例。比较2组图像质量评分、扫描长度、辐射剂量和患者对不同屏气方式感觉的舒适度。以CGA为诊断金标准,评价2组扫描诊断冠状动脉狭窄的准确度。结果:100例患者均成功完成CCTA和CGA检查,CCTA共显示636个冠状动脉节段,2组图像质量无统计学差异(P>0.05);A组平均扫描长度值为(148±8)mm(范围:128~160mm),B组平均扫描长度值为(118±6)mm(范围:100~140mm),B组平均扫描长度比A组减少约20.2%,有效辐射剂量降低约35%,差异有统计学意义(P<0.05);2组扫描图像CCTA诊断为冠状动脉狭窄的结果均与CGA高度一致,Kappa系数均大于0.8;结论:呼气末屏气行CCTA检查可减少扫描长度,从而有效降低辐射剂量,但对图像质量和诊断准确度无影响,具有很高的应用价值。Purpose:To explore the application of end expiratory breath holding and end inspiratory breath holding in coronary CT angiography.Methods:A total of 100 cases of patients with coronary artery stenosis diagnosed by CCTA and coronary angiography(CGA)were enrolled in the study.They were divided into two groups in an even-odd order.Each group had 50 cases of patients.The odd-numbered group(group A)was tested with the conventional deep end inspiratory breath holding,and the even-numbered group(group B)was tested by the deep end expiratory breath holding.The image quality score,scanning length and radiation dose were compared between the two groups.CGA was used as the standard to evaluate the accuracy of diagnosing of coronary artery stenosis in the two groups.Results:All 100 patients completed CCTA and CGA examination successfully.A total of 636coronary segments were displayed by CCTA,and there was no significant difference in image quality between the two groups(P>0.05).The average scanning length in group A was(148±8)mm(range:128-160 mm),and the average scanning length in group B was(118±6)mm(range:100-140 mm).Compared with group A,the average scanning length and effective radiation dose of group B were reduced by about 20.2%and 35%respectively,with statistical significance(P<0.05).The results of coronary artery stenosis diagnosed by CCTA in both groups were highly consistent with CGA,and the Kappa coefficient was greater than 0.8.Conclusions:CCTA examination with end expiratory breath holding can reduce the scanning length and effectively reduce the radiation dose,but the image quality and diagnostic accuracy are not affected.So it is worth promoting and applying.

关 键 词：扫描长度 冠状动脉 图像质量 辐射剂量 

分 类 号：R445.2[医药卫生—影像医学与核医学]