| 汪芳,郝万庆,杨利莉,郑静瑶,哈若水,王泽润,曹永佩,黄飞.256排宽体探测器CT智能心电门控技术在不控制心率患者冠状动脉CTA中的应用[J].中国医学影像技术,2017,33(7):1080~1084 |
| 256排宽体探测器CT智能心电门控技术在不控制心率患者冠状动脉CTA中的应用 |
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| 投稿时间：2016-11-07 修订日期：2017-03-01 |
| DOI：10.13929/j.1003-3289.201611037 |
| 中文关键词: 血管造影术 体层摄影术，X线计算机 冠状动脉疾病 |
| 英文关键词:Angiography Tomography, X-ray computed Coronary disease |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨256排宽体探测器CT智能心电门控技术对不控制心率患者CT冠状动脉成像的图像质量及可诊断性。方法 200例疑似冠心病的患者接受256排宽体探测器CT冠状动脉成像，采用智能心电门控扫描，根据扫描患者实时心率分成4组，A组（心率≤69次/分）、B组（心率为70~80次/分）、C组（心率为81~90次/分）、D组（心率≥91次/分），每组50例。由2名有心血管CT诊断经验的医师以盲法对4组冠状动脉成像的图像质量及可诊断性进行评价，并比较各组的辐射剂量。结果 4组患者年龄、性别、体质量指数差异无统计学意义；图像质量主观评分差异有统计学意义（P<0.05）。200例患者共评价600支血管2 575个节段，4组图像节段水平、患者水平、血管水平的可诊断率差异均无统计学意义（P均>0.05）。A~D组的有效辐射剂量分别为（1.05±0.48）mSv、（2.41±1.20）mSv、（1.27±0.55）mSv、（2.66±1.12）mSv，差异有统计学意义（F=29.22，P<0.001）。结论 Revolution CT宽体探测器智能心电门控技术在不同心率患者单个心动周期完成冠状动脉CTA检查具有可行性，并提高了中高心率患者检查成功率及图像质量。 |
| 英文摘要: |
| Objective To explore the image quality and diagnostic efficiency of coronary CTA (CCTA) in patients without heart rate (HR) control by optimizing acquisition phase with auto-ECG-gating technology using 256-row wide-volume detector. Methods Totally 200 patients with suspected coronary artery disease (CAD) were selected and underwent CCTA with auto-ECG-gating on a 256 row wide detector CT (Revolution CT). Patients were divided into 4 groups according to the real-time HR, group A (n=50): HR≤69 bpm; group B (n=50): HR 70—80 bpm; group C (n=50): HR 81—90 bpm; group D: HR≥91 bpm (n=50). CCTA images quality and diagnostic rate were assessed by two experienced radiologists blindly, and effective radiation dose were compared among 4 groups. Results There were no significant differences of age, sex, and body mass index among 4 groups (all P>0.05), and there was significant difference of image quality score among 4 groups (P<0.05). Totally, 800 coronary arteries and 2 575 segments in 200 patients were assessed. There had no significant difference of diagnostic rate among four groups derived from the segment, coronary artery and patients (all P>0.05). The effective radiation dose in A—D groups were (1.05±0.48)mSv, (2.41±1.20)mSv, (1.27±0.55)mSv, (2.66±1.12)mSv, and the difference was significant (F=29.22, P<0.001). Conclusion It is feasible to perform CCTA in single cardiac cycle in patients with arbitrary heart rate by auto-ECG-gating using Revolution CT equipped wide-volume detector. And it can improve image quality and success ratio in patients with moderate and high heart rate. |
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