多排螺旋CT在高心率冠状动脉血管成像的质量评估及可行性分析  

Quality Evaluation of Multi-Row Spiral CT Coronary Angiography in High Heart Hate Patients and its Feasibility Analysis

作　　者：王伟平 郑晓林 王彬 吕铭亮 WANG Weiping;ZHENG Xiaolin;WANG Bin(Department of Radiology,Dongguan Kanghua Hospital,Dongguan,Guangdong Province 523000,P.R.China)

机构地区：[1]东莞康华医院放射科,523000

出　　处：《临床放射学杂志》2024年第10期1697-1702,共6页Journal of Clinical Radiology

摘　　要：目的通过对图像质量的分析,探讨多排螺旋CT在高心率冠状动脉成像的可行性。方法对205例行冠状动脉CT血管造影(CTA)的患者资料进行回顾性分析,采用回顾性心电门控结合螺距-心率自动匹配技术采集数据。按心率不同分为A、B两组,其中A组110例,心率<80次/分;B组95例,心率≥80次/分。在所选择的增强扫描原始图像及冠状动脉曲面重组(CPR)上评估两组患者的图像质量,测量右冠状动脉(RCA)、左冠状动脉主干(LM)、左前降支(LAD)和左回旋支(LCX)的CT值,计算主动脉根部的信噪比(SNR)和噪声水平。记录并进一步分析两组间螺距与图像质量及辐射剂量的关系。对两组的观察数据进行统计学分析和比较。结果A组90%(99/110)重组期相位于66%~80%RR间期,B组75.78%(72/95)重组期相位于35%~49%RR间期,两组间具有显著性差异(P<0.05)。A、B两组患者的RCA、LAD、LCX的图像质量等级例数及出现伪影的节段数均无显著性差异(P>0.05),A、B组图像的主动脉根部噪声水平分别是(21.99±4.05)HU和(22.25±3.25)HU,SNR分别是23.11±5.60和22.07±5.04,两组间数据比较均无显著性差异(P>0.05);两组各冠状动脉强化CT值均高于300 HU,A组RCA、LM、LAD、LCX的CT值分别为(430.18±78.92)HU、(497.41±87.46)HU、(416.42±78.95)HU和(391.16±87.74)HU,高于B组[依次为(384.57±81.08)HU、(386.33±74.63)HU、(375.27±84.12)HU和(356.06±87.21)HU],差异有统计学意义(P<0.05)。A组自动匹配螺距0.18,B组自动匹配螺距0.16,两组间螺距有差异;两组患者的CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)及有效辐射剂量(ED)差异无统计学意义(P>0.05)。结论多排(256层)螺旋CT选择较小螺距结合收缩末期的重组期相在高心率冠状动脉成像具有良好的效果,图像质量均能满足诊断要求,说明其具有可行性和值得临床应用推广。Objective To explore the feasibility of multi-row spiral CT coronary angiography in high heart rate patients through analyzing the imaging quality.Methods 205 cases of coronary artery CT angiography(CCTA)were retrospectively analyzed,and the data were collected by retrospective electrocardiogram gating combined with automatic pitch-heart rate matching.They were divided into two groups according to heart rate,group A 110 cases,heart rate and<80 bpm;Group B,95cases and heart rate≥80 bpm.The imaging quality of selected enhanced original imaging and CPR in both groups and the CT values of right coronary artery(RCA),left main trunk(LM),left anterior descending branch(LAD)and left circumflex(LCX)were measured,noise-signal ratio(SNR)and noise level in aortic root were counted.The relationship between pitch and imaging quality and radiation dose between the two groups was recorded and further analyzed.The observed data of both groups were statistically treated and compared.Results Reconstruct the phases were situated 66%-80%RR interval in 90%patients(99/110 cases)in A group as well as reconstruct the phases were situated 35%-49%RR interval in 75.78%patients(72/95 cases)in B group which had significant difference(P<0.05).The imaging quality grade and section number with artifacts in RCA,LAD,left anterior descending branch and LCX hadn’t all significant difference between A and B group(P>0.05).In A and B group,noise level in aortic root were 21.99±4.05 and 22.25±3.25 respectively,noise-signal ratio were 23.11±5.60 and 22.07±5.04 respectively that hadn’t all significant difference between A and B group(P>0.05).The CT values of All coronary arteries were over 300 HU in both groups.In A group,the CT values of right coronary artery,left main trunk,left anterior descending branch and left circumflex were respectively 430.18±78.92,497.41±87.46,416.42±78.95 and 391.16±87.74 which were higher than B group(384.57±81.18,386.33±74.63,375.27±84.12 and 356.06±87.21 in order)and there was significant difference between

关 键 词：冠状动脉CTA 高心率 期相选择 重组期相 图像质量 比较与分析 

分 类 号：R543.3[医药卫生—心血管疾病] R816.2[医药卫生—内科学]