双次前门控大螺距扫描在双源CT冠状动脉成像中的应用

摘要

Objective To discuss the clinical value of double prospective ECG-gated high-pitch spiral (Double-Flash) acquisition in dual-source CT (DSCT) coronary angiography (CTCA).Methods According to the inclusion criteria, 53 patients with suspected coronary artery disease (CAD) undergoing CTCA in Double-Flash acquisition were enrolled as study group.40 patients according to the same criteria and undergoing sequential acquisition were selected as control group.The image quality of coronary artery, effective radiation dose and diagnostic accuracy were compared between the two groups.Results There was no significant difference in clinical data between study and control group (P>0.05).Proportion of coronary segments with diagnosable image quality (IQ) had no significant difference between the two groups (P>0.05), while, the proportion with excellent IQ in study group was lower than that in control group (P<0.05).The effective radiation dose of study group (2.08±0.39) mSv was lower than that of control group (3.67±1.11) mSv, with significant difference (P<0.05).The diagnostic accuracy was 97.91% in study group and 98.76% in control group, respectively, without significant difference (P>0.05).Conclusion DSCT Double-Flash CTCA with diagnosable image quality and high diagnostic accuracy is able to be used for patients with stable HR≤75 bpm at a lower radiation dose.%目的 探讨双次前门控大螺距(Double-Flash)扫描行双源CT(DSCT)冠状动脉成像(CTCA)的临床应用价值.方法 收集符合纳入标准的53例可疑冠心病患者作为研究组,行DSCT Double-Flash扫描;以相同标准选取同期行前门控序列扫描的患者40例作为对照组.比较两组冠状动脉图像质量、有效辐射剂量(ED)及诊断准确性.结果 研究组、对照组患者一般临床资料差异无统计学意义(P>0.05).两组可用于诊断的血管段所占比例无统计学差异(P>0.05),研究组图像质量优的血管段所占比例小于对照组,差异有统计学意义(P<0.05).研究组和对照组平均ED分别为(2.08±0.39)mSv、(3.67±1.11)mSv,差异有统计学意义(P<0.05).两组诊断冠心病的准确率分别为97.91%、98.76%,差异无统计学意义(P<0.05).结论 对于心率相对平稳且≤75bpm的患者,DSCT Double-Flash CTCA扫描具有临床可行性,能在保证图像质量和诊断准确率的前提下明显降低辐射剂量.