低辐射剂量宽探测器CT智能心电门控技术对儿童先天性心脏病冠状动脉的可视性评估  

Feasibility of Auto-ECG-Gating Technique with Low Dose Wide-Detector Coronary CT Angiography in Display of the Coronary Artery in Pediatric Congenital Heart Disease

作　　者：葛文 宋修峰 邱庆琢 泮思林 GE Wen;SONG Xiufeng;QIU Qingzhuo;PAN Silin(Heart Center,Qingdao Women and Children's Hospital,Qingdao 266034,China;不详)

机构地区：[1]青岛市妇女儿童医院影像科,山东青岛266034 [2]青岛市妇女儿童医院心脏中心,山东青岛266034

出　　处：《中国医学影像学杂志》2023年第2期118-123,共6页Chinese Journal of Medical Imaging

基　　金：青岛市2019年度医药科研指导计划项目(2019-WJZD127)。

摘　　要：目的结合智能心电门控技术探讨低辐射剂量冠状动脉血管成像(CCTA)对先天性心脏病患儿冠状动脉成像的检出率、图像质量及辐射剂量。资料与方法前瞻性招募2017年11月—2020年9月青岛市妇女儿童医院确诊或拟确诊为先天性心脏病患儿79例,应用80 kVp低管电压、智能心电门控前瞻性心电门控轴扫序列行CCTA扫描。按年龄分为≤3个月18例、≥4个月~<1岁29例及≥1岁32例,研究低电压智能心电门控扫描技术对不同年龄患儿行CCTA的可行性,并分析3组图像质量、冠状动脉检出率、显示效果、主动脉根部CT值、显示效果及有效辐射剂量(ED)。结果3组11个节段总检出率为90.1%(783/869),左冠状动脉总体检出率为90.4%(500/553),右冠状动脉总体检出率为89.6%(283/316)。≤3个月、≥4个月~<1岁及≥1岁组冠状动脉检出率分别为84.8%(168/198)、90.3%(288/319)及92.9%(327/352),差异有统计学意义(χ^(2)=9.225,P=0.010)。右冠状动脉起源部位显示效果最佳检出率达100%(79/79),左前降支远段、左回旋支远段及右冠状动脉远段最差,检出率低于80%。3组的噪声指数分别为(10.4±2.0)Hu、(9.7±1.8)Hu和(10.9±2.2)Hu,主动脉根部CT值分别为(609±122)Hu、(547±110)Hu和(568±93)Hu。3组的ED分别为(1.33±0.32)mSv、(0.99±0.16)mSv和(0.78±0.14)mSv,差异有统计学意义(F=39.750,P<0.05),年龄越小,ED越大。结论对于>1岁的先天性心脏病患儿,低电压宽探测器CT前瞻性心电门控CTA扫描ED较小,对冠状动脉检出率高。对于<1岁,尤其是≤3个月的患儿,冠状动脉检出率较高,但ED略大,应结合临床需求综合考虑。Purpose To evaluate the display of coronary artery segments,image quality and effective dose of wide-detector coronary CT angiography(CCTA)with prospective auto-ECG-gating technique and low tube voltage in children with congenital heart disease(CHD).Materials and Methods Seventy-nine children with CHD from November 2017 to September 2020 were prospectively enrolled,who underwent CCTA using 80 kVp tube voltage and prospective ECG gated axial scanning sequence with auto-gating.All children were divided into three groups according to their age:18 case of≤3 months,29 cases 4 months to 1 year old and 32 cases≥1 year.The feasibility of lowvoltage intelligent ECG gated scanning technology for CCTA on children of different ages was studied,and the differences in image quality,coronary artery detection rate,display rate of coronary artery segments,CT value of aortic root,display effect and effective radiation dose(ED)in the three groups were analyzed.Results In all three groups,the overall display rate of eleven segments was 90.1%(783/869),the overall display rate of left coronary artery was 90.4%(500/553),the overall display rate of right coronary artery was 89.6%(283/316).The display rates of three groups were 84.8%(168/198),90.3%(288/319)and 92.9%(327/352),respectively,with significant differences among three groups(χ^(2)=9.225,P=0.010).The origin of the right coronary artery was best shown,with a detection rate of 100%(79/79).The distal segment of the left anterior descending branch,the distal segment of the left circumflex branch and the distal segment of the right coronary artery were worst shown,with a detection rate of less than 80%.The mean noise indices in the three groups were(10.4±2.0)Hu,(9.7±1.8)Hu and(10.9±2.2)Hu,respectively;the mean CT values of aortic root were(609±122)Hu,(547±110)Hu and(568±93)Hu,respectively.The ED were(1.33±0.32)mSv,(0.99±0.16)mSv and(0.78±0.14)mSv,respectively,with significant differences among three groups(F=39.750,P<0.05),and ED was larger in younger groups.Conclusion

关 键 词：先天性心脏病 体层摄影术 X线计算机 前瞻性心电门控 冠状动脉 

分 类 号：R445.3[医药卫生—影像医学与核医学] R541.1[医药卫生—诊断学]