320排探测器自由呼吸冠状动脉CT血管造影在老年病人中应用的可行性和临床价值  

Feasibility and application value of free-breathing coronary CT angiography using 320-MDCT in elderly patients

作　　者：王璇 唐无量 邵海磊 徐秋贞[1] WANG Xuan;TANG Wuliang;SHAO Hailei;XU Qiuzhen(Department of Medical Imaging,Jiangbei Branch of Zhongda Hospital Affiliated Southeast University,Nanjing 210048,China)

机构地区：[1]东南大学附属中大医院江北院区医学影像科,江苏省南京市210048

出　　处：《实用老年医学》2024年第8期792-796,共5页Practical Geriatrics

基　　金：江苏省医学会伦琴影像科研专项资金项目[SYH-3201150-0009(2021004)]。

摘　　要：目的探讨使用320排探测器CT在老年病人自由呼吸状态下进行冠状动脉成像(CCTA)检查的可行性和临床价值。方法回顾性选取2022年10月至2023年5月在东南大学附属中大医院使用320排探测器CT进行CCTA扫描的老年病人100例,根据扫描时呼吸状态分为自由呼吸组和屏息组,每组50例。测量2组主动脉(aorta)、右主干(RCA)、左主干(LM)的CT值、信噪比(SNR)、对比噪声比(CNR)和冠周脂肪组织的标准差(SD)、有效剂量(ED)并比较。两名医师采用4分法对2组冠状动脉15分段的图像质量进行双盲评分并比较,使用Kappa检验评估两位医师主观评分的一致性。结果2组主动脉、RCA、LM的CT值、SNR和CNR差异均无统计学意义(P>0.05)。2组的主观评分以及高心率(>75次/min)与中低心率(≤75次/min)的主观评分差异均无统计学意义(P>0.05),两位医师的主观评分一致性较好(Kappa值为0.633和0.720),自由呼吸组的ED小于屏息组(P<0.05)。结论老年病人使用320排探测器CT行自由呼吸CCTA具有可行性,可以在较低的辐射剂量下获得较高的图像质量。Objective To explore the feasibility and application value of 320-Multi-Detector CT(320-MDCT)for free-breathing coronary CT angiography(CCTA)in the elderly patients.Methods A total of 100 elderly patients who underwent CCTA scanning using 320-MDCT at Zhongda Hospital Southeast University from October 2022 to May 2023 were selected retrospectively.The patients were divided into free-breathing group(n=50)and breath-holding group(n=50)based on their respiratory status during the scan.The CT values,signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)of the aorta,right coronary artery(RCA)and left main coronary artery(LM)and effective dose(ED),standard deviation(SD)of pericoronal adipose tissue in the two sets of images were measured and compared.Two physicians used a 4-point method to perform a double-blind evaluation of the image quality of 15 coronary segments in the two groups,and Mann-Whitney U test was used to evaluate the subjective ratings.Kappa test was used to assess inter-rater agreement of the two physicians.Results The differences in CT values,SNR and CNR of aorta,RCA and LM between the two groups were not statistically significant(P>0.05).There was no significant difference in subjective scores between the two groups and the same results were observed in the high heart rate group(>75 bpm)and the medium-low heart rate group(≤75 bpm)(P>0.05).The consistency of subjective scores between the two physicians was good(kappa values were 0.633 and 0.720),and the level of ED in the free-breathing group was lower than that in the breath-holding group(P<0.05).Conclusions Free-breathing CCTA may be feasible on 320-MDCT with high image quality and low radiation dose in the elderly patients.

关 键 词：320排探测器 自由呼吸 冠状动脉CT血管造影 

分 类 号：R814.43[医药卫生—影像医学与核医学]