基于多重优化组合下的心电脉冲技术在回顾性心电门控冠状动脉CT血管成像检查中的应用  

Use of electrocardiogram-pulsing based on multiple optimized combinations in retrospective electrocardio-gram-gated coronary computerized tomography angiography

作　　者：朱维聪 王彬 曾慧芸 范林 Zhu Weicong;Wang Bin;Zeng Huiyun;Fan Lin(Department of Radiology,Dongguan Kanghua Hospital,Guangdong 523000,China)

机构地区：[1]东莞康华医院放射科,523000

出　　处：《实用医技杂志》2022年第10期1013-1018,I0001,共7页Journal of Practical Medical Techniques

摘　　要：目的评价基于多重优化组合下的心电脉冲技术(ECG-pulsing)对降低回顾性心电门控冠状动脉CT血管成像(CCTA)辐射剂量的价值。方法120例体质量指数(BMI)≤30 kg/m2的患者接受CT冠状动脉检查,分成A、B、C 3组。A组使用传统方法进行CT冠状动脉成像检查;B组使用标准心电脉冲窗技术,全剂量扫描范围为30%~80%RR间期;C组依据患者心率设置心电脉冲窗全剂量扫描范围(心率≤70次/min,设60%~80%RR间期为全剂量扫描范围;心率70~90次/min,设30%~80%RR间期为全剂量扫描范围)。所有患者心律平稳,心率<90次/min,扫描管电压100 kV,管电流采用自动管电流调制技术(ATCM)(其中B组和C组均采用ECG-pulsing+ATCM),螺距采用螺距-心率自动匹配技术及应用迭代重建算法重建图像。记录并比较3组病例CCTA扫描的辐射剂量,同时对3组病例的图像质量进行评分。结果A、B、C 3组病例的图像质量评分差异无统计学意义(P>0.05)。与A组[(8.9±2.3)mSv]有效剂量相比,B组[(6.9±1.4)mSv]降低约22.8%,C组[(5.6±1.6)mSv]降低约37.4%,3组间比较差异均有统计学意义(P<0.05)。结论应用ECG-pulsing可在保证诊断图像质量前提下,显著降低患者所接受的辐射剂量,在回顾性心电门控冠状动脉CTA检查中具有重要价值。Objective To investigate the value of ECG-pulsing based on multiple optimized combinations in reducing the radiation dose during retrospective electrocardiogram(ECG)gated coronary computerized tomog-raphy angiography(CCTA).Methods A total of 120 patients with body mass index(BMI)≤30 kg/m2 under-going CCTA were divided into groups A,B and C.The group A underwent conventional CCTA;in group B,regular electrocardiogram(ECG)-pulsing window was used with a full-dose scanning range at 30%to 80%of RR interval;in group C,heart rate(HR)dependent ECG-pulsing window was used,with a full-dose scanning range at 60%to 80%of RR interval when HR was≤70 beats/min,and at 30%to 80%of RR interval when HR was 70 to 90 beats/min.All patients were in stable heart rhythm with heart rate below 90 beats/min.For the scanning,tube potential of 100 kV,automatic tube current modulation(ATCM)(as in groups B and C with ECG pulsing+ATCM),and automatic pitch matching according to HR were used.An iterative reconstruction algorithm was used to reconstruct the images.The radiation doses of scanning in CCTA were recorded and compared among the three groups.The image quality in the three groups was also rated.Results There was no statistically significant differ-ence in the image quality rating among the groups A,B and C(P>0.05).Compared with the effective dose in group A[(8.9±2.3)mSv],there was a reduction of nearly 22.8%in group B[(6.9±1.4)mSv]and nearly 37.4%in group C[(5.6±1.6)mSv],with statistically significant difference(P<0.05)among the three groups.Conclusion The use of ECG-pulsing can significantly reduce the radiation dose on patients while maintaining the quality of diagnostic images,and thus is of great importance in retrospective ECG-gated coronary CTA stud-ies.

关 键 词：体层摄影术 X线计算机 冠状动脉疾病 辐射剂量 辐射防护 

分 类 号：R816.2[医药卫生—放射医学] R543.3[医药卫生—临床医学]