16cm宽体探测器CT单个心动周期冠状动脉成像在心律不齐患者中的应用——可行性研究

摘要

Objective To investigate the feasibility of coronary CT angiography(CCTA)in single cardiac cycle in patients with cardiac arrhythmia using 16 cm wide-detector CT scanner. Methods A retrospective study was undertaken in 166 cases for CCTA which had heart rate fluctuation. These patients had heart rate fluctuation ≥5 bpm and were further divided into two groups:Group A(n=95, 5 bpm≤HR fluctuation≤10 bpm)and Group B(n=71, HR fluctuation>10 bpm). The subjective quality and radiation dose were compared. Results There were no significant differences in general information of patients between the two groups(P>0.05). The mean heart rate of the two groups were similar(67.6±12.4 bpm vs. 68.1±11.4 bpm). However, Group B had significantly higher heart rate fluctuations than Group A(38.2±35.9 bpm vs. 7.8±1.2 bpm, P<0.05). 498 coronary arteries and 2 150 segments in 166 patients were assessed. All images were acceptable for clinical diagnosis(≥3 scores). Compared with Group A, the image quality scores decreased slightly in Group B(3.74±0.52 vs. 4.08±0.56), but no statistical difference was found(P>0.05). The mean effective dose was 2.2±1.1 mSv and 2.6±1.4 mSv in Groups A and B, respectively. There was a significant difference in total effective radiation dose between two groups(P<0.05).Conclusion Single cardiac cycle scan combined with snapshot freeze(SSF)were feasible for coronary CT angiography in patients with heart rhythms using 16 cm wide-detector CT scanner, which can maintain the diagnostic image quality with low radiation dose.%目的 探讨16cm宽体探测器CT对心律不齐患者单个心动周期冠状动脉成像的可行性.方法 回顾性分析自由呼吸条件下心率波动≥5 bpm患者资料166例,根据心率波范围分A组(5 bpm≤心率波动≤10 bpm)95例、B组(心率波动>10 bpm)71例.比较两组图像质量及辐射剂量.结果 两组间一般资料无显著性差异(P>0.05);平均心率分别为68.1±11.4 bpm(A 组)、67.6±12.3 bpm(B 组),无统计学差异(P>0.05);心率波动分别为7.8±1.2 bpm(A 组)、38.2±35.9 bpm (B 组),有明显统计学差异(P<0.001).166例患者共评价498分支水平血管,共2150节段,所有图像均可满足临床诊断(≥3分).与 A 组比较,B 组主观图像质量评分略有下降[4.08±0.56(A 组)比3.74±0.52(B 组)],两组无明显统计学差异(P>0.05).A、B两组平均有效剂量分别为2.2±1.1 mSv和2.6±1.4 mSv,差异有统计学意义(P<0.05).结论 16 cm宽体探测器CT在心律不齐患者单个心动周期完成冠状动脉成像并结合SSF技术具有可行性,能以较低的辐射剂量获得满足临床诊断的图像.