| 柴学,张龙江,周长圣,赵艳娥,黄伟,卢光明.窦性心动过速患者双源CT冠状动脉成像：最佳期相及平均心率和心率变异性对影像质量影响的研究[J].中国医学影像技术,2008,24(9):1311~1313 |
| 窦性心动过速患者双源CT冠状动脉成像：最佳期相及平均心率和心率变异性对影像质量影响的研究 |
| Coronary artery imaging in patients with sinus tachycardia using dual-source CT : Optimal reconstruction phase and the effect of heart rate and heart rate variability on image quality |
| 投稿时间：2008-05-22 修订日期：2008-08-22 |
| DOI： |
| 中文关键词: 冠状动脉 体层摄影术, X线计算机 血管造影术 心动过速 |
| 英文关键词:Coronary artery Tomography, X-ray computed Angiography Tachycardia |
| 基金项目: |
| 作者 | 单位 | E-mail | | 柴学 | 南方医科大学南京临床学院, 南京军区总医院医学影像科, 江苏 南京 210002 | 20600412@163.com | | 张龙江 | 南方医科大学南京临床学院, 南京军区总医院医学影像科, 江苏 南京 210002 | | | 周长圣 | 南方医科大学南京临床学院, 南京军区总医院医学影像科, 江苏 南京 210002 | | | 赵艳娥 | 南方医科大学南京临床学院, 南京军区总医院医学影像科, 江苏 南京 210002 | | | 黄伟 | 南方医科大学南京临床学院, 南京军区总医院医学影像科, 江苏 南京 210002 | | | 卢光明 | 南方医科大学南京临床学院, 南京军区总医院医学影像科, 江苏 南京 210002 | cjr.luguangming@vip.163.com |
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| 中文摘要: |
| 目的 探讨窦性心动过速(＞100次/分)患者双源CT冠状动脉成像的最佳期相，评价平均心率和心率变异性对冠状动脉影像质量的影响。方法 47例窦性心动过速患者进行双源CT冠状动脉成像。原始数据先行自动化重建优选出最佳收缩期和最佳舒张期的冠状动脉影像，再以R-R间期的5%为固定间隔行多期相重建获得多期相影像，以4分法评定系统进行影像质量评价。按照美国心脏病协会的冠状动脉分段原则进行分段。使用多组等级资料的χ2检验对总体及各支血管的多期相影像评分进行统计检验，并评价平均心率及心率变异性与冠状动脉影像质量的相关性。结果 47例患者平均心率(110.15±7.95)次/分。总体冠状动脉最佳期相位于自动重建所选的最佳收缩期(86%)、R-R间期的45％(83％)和40％(83％)，但三者之间无统计学差异(P＞0.05)。右冠状动脉(RCA)的最佳期相为R-R间期的45%(95％)，左前降支(LAD)为35%(85％)，左回旋支(LCX)为40%(77％)。平均心率与总体冠状动脉影像质量无相关性，与LCX影像质量呈负相关(r=-0.420，P=0.003)，与RCA和LAD无相关性(P＞0.05)；心率变异性与总体冠状动脉影像质量无相关性，与LAD影像质量呈正相关(r=0.400，P=0.005)。结论 窦性心动过速患者在舒张期难以获得满意的影像，冠状动脉最佳重建期相为R-R间期的40%~45%及自动重建所获最佳收缩期，各支冠状动脉的最佳期相不同，集中于R-R间期的35%~45%。平均心率和心率变异性对总体冠状动脉影像无影响，平均心率仅对LCX影像质量有影响，而心率变异性仅对LAD影像质量有影响。 |
| 英文摘要: |
| Objective To explore the optimal reconstruction phase of coronary artery imaging in patients with sinus tachycardia (>100 beat per minute, bpm) by dual-source CT coronary angiography (CTCA), and to assess the effect of average heart rate (aHR) and heart rate variability on coronary artery image quality. Methods Forty-seven patients with sinus tachycardia underwent CTCA. Best systolic and diastolic coronary arteries were reconstructed with a dedicated automatic software and then CT data was reconstructed with the R-R interval of 5%; image quality was assessed using four-score method. Coronary arteries were segmented according to the guideline of American Heart Association. The phase with optimal image quality was computed; the effect of aHR and heart rate variability on image quality was analyzed. Results aHR in the 47 patients was (110.15±7.95) bpm. The optimal reconstruction window for phase reconstruction technique was at the automatic optimal systolic phase (86％) and the 45% of R-R interval (83％) and 40% of R-R interval (83%). But there was not significant difference in image quality among 40%, 45% of R-R interval and automatic best systolic phase (P>0.05). The optimal image quality of right coronary artery (RCA) was acquired at the 45% of R-R interval (95％), left anterior descending artery (LAD) at 35% (85％), left circumflex artery (LCX) at 40% (77％). aHR had no correlation with image quality of coronary angiography. Negative correlation was found between aHR and image quality of LCX (r＝-0.420, P=0.003). Heart rate variability had no correlation with image quality of coronary angiography; positive correlation was found between heart rate variability and image quality of LAD (r＝0.400, P=0.005). Conclusion The Optimal image quality of CTCA was acquired at the 40%-45% of R-R interval and automatic best systolic phase for patients with sinus tachycardia. Various reconstruction windows should be used for each coronary artery because of non-optimal image quality in a single reconstruction phase.aHR had no correlation with image quality of coronary angiography with DSCT; as well, heart rate variability had no correlation with average image quality of coronary angiography. |
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