摘要
目的:评估多层螺旋CT(MSCT)前瞻性心电门控冠脉扫描模式对冠状动脉狭窄程度显示的价值及图像质量,并评估患者接受的辐射剂量。材料与方法:将104例拟诊冠心病患者分两组分别行前瞻性和回顾性心电门控冠状动脉CTA扫描,采用容积再现技术重建(VR)、最大密度投影(MIP)、多层面重组(MPR)和二维曲面重建(CPR)等多种重组技术显示各节段冠状动脉,评价其图像质量,并分别计算有效辐射剂量。结果:两组患者(除回顾组平均心率较前瞻组略高)临床资料匹配性、图像质量的评价一致性良好,差异无统计学意义。前瞻组符合诊断要求的冠状动脉节段为95.6%(568/594),与回顾组冠状动脉节段的96.5%(614/636)比较,差异无统计学意义。前瞻组50例患者中594个冠状动脉节段中,MSCT诊断冠脉狭窄程度≥50%的节段为69个。回顾组54例患者中636个冠状动脉节段中,MSCT诊断冠脉狭窄程度≥50%的节段为61个。前瞻组平均辐射剂量为(3.62±0.37)mSv,回顾组平均辐射剂量为(15.18±0.96)mSv,两组间差异有统计学意义(P<0.001),两组辐射剂量有明显差异。结论:256层螺旋CT冠状动脉前瞻性心电门控技术评估冠状动脉成像图像质量及管腔狭窄的效果与回顾性心电门控扫描技术相似,但前者的有效辐射剂量明显减少。
Purpose： To evaluate the value in showing coronary artery stenosis degree, image quality and radiation dose using propective electrocardiogram （ECG） gating 256-slice spiral computed tomography coronary angiography （CTCA）. Materials and Methods： 104 patients with suspected or known coronary artery disease（CHD） were divided into two groups which underwent 256 CTCA with prospective or retrospective ECG gating computed tomography coronary angiography（CTCA）. Maximum intensityprojection（ MIP）, volume rendering（ VR）, Multiplanar reconstruction （MPR）, and curved planar reconstruction（CPR） were made to diagnosis the coronary arteries. The image quality and individual radiation exposure dose were estimated . Results ： Image quality was not inflused by age, body mass index （BMI）. Segments of CTA images were con- sistent with the lumen evaluation , there were 95.6% （568/594） in prospective ECG gating group , 96. 5% （614/636） in retrospective ECG gating group, They were similar （ P 〉 0. 05 ）. Segments of CTA images in showing severe stenosis （≥ 50% ） were 69/594 in prospective ECG gating group and 61/636 segments as those of in retrospective ECG gating group. The mean effective radiation dose of prospective ECG-gating group （ 3.62 ±0. 37 ） mSv was significantly lower than that of retrospective ECG-gating group（ 15.18 ±0. 96） mSv, P 〈 0. 001. Conclusion： Compared with retrospective CTA, prospective CTA has similar performance in showing coronary artery anatomy structure, stenosis degree and image quality , but lower effective radiation dose in patients.
出处
《现代医用影像学》
2013年第1期13-17,共5页
Modern Medical Imageology
