摘要: |
目的: 探讨心率<75次/min患者在自由呼吸状态下行320排CT冠脉造影(coronary CT angiography, CCTA)的可行性,并评价图像质量及辐射剂量。方法: 共有94例心率<75次/min的疑似冠心病患者,采用联影320排CT以前瞻性心电门控技术,单个心动周期扫描行CCTA。根据患者呼吸方式分为2组:屏气组47例,自由呼吸组47例。测量各组患者主动脉的信噪比(SNR),左主干(LM)近段和中段、前降支(LAD)近段、回旋支(LCX)近段、右冠状动脉(RCA)近段及中段的对比噪声比(CNR),主动脉、LM和RCA的CT值及主动脉的标准值。由2名放射科医生以5分法对94例患者进行冠脉18分段图像质量进行双盲评价,分数 ≥ 3分符合诊断标准。结果: 2组患者的CNR、SNR和CT值差异均无统计学意义。屏气组和自由呼吸组冠脉节段评分5分者分别占68.8%、67.4%,4分者分别占18.0%、20.3%,3分者分别占10.2%、10.4%,差异无统计学意义。自由呼吸组辐射剂量少于屏气组(P<0.01)。结论: 对于心率<75次/min的患者,采用自由呼吸与标准屏气进行320排宽体CT进行CCTA的图像质量无明显差异,说明对于该类患者,自由呼吸CCTA是一种可行方案。 |
关键词: 冠脉CT造影 心率 自由呼吸 标准屏气 图像质量 |
DOI:10.12025/j.issn.1008-6358.2021.20202440 |
分类号:R543.3 |
基金项目:国家自然科学基金重大研究计划(91859107),上海市科学技术委员会"科技创新行动计划"产学研医合作领域项目(18DZ1930102),上海市科学技术委员会医学引导类(中、西医)科技支撑项目(19411965500),上海市临床重点专科项目(W2019-018),复旦大学附属中山医院临床专项(2018ZSLC22). |
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Feasibility of coronary CT angiography in single cardiac cycle with wide-body detector in free-breathing state |
ZHOU Lin-xi1, LU Xiu-liang1, ZHU Shuo1, ZHOU Guo-feng1, XÜ Shi-jie2, ZOU Yi-xuan2, YAN Cheng1
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1.Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China;2.Shanghai Lianying Medical Technology Co., Ltd., Shanghai 200032, China
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Abstract: |
Objective: To investigate the feasibility of 320 slice CT angiography of coronary artery in patients with heart rate <75 times per minute in free-breathing state and to evaluate the image quality and radiation dose.Methods: Coronary artery CT imaging was performed in a single cardiac cycle using Lianying 320 slice CT by prospective electrocardiogram gating technique for 94 patients with suspected coronary heart disease and heart rate lower than 75 times per minute. The patients were divided into two groups according to their breathing patterns. There were 47 cases of breath-holding in group A and 47 cases of free-breathing in group B. Signal to noise ratio (SNR) of the aorta, contrast to noise ratios (CNR)of the aorta, left main trunk, proximal anterior descending artery, proximal circumflex artery, proximal and middle right coronary artery, were measured. Two radiologists evaluated 18 segments of the coronary artery of 94 patients by 5-point and double-blind methods, and score ≥ 3 meet the diagnostic requirements.Results: There was no significant difference in CNR, SNR, and CT values between the two groups. In group A and B, percentages of patients scored 5, 4, and 3 were 68.8% and 67.4%, 18.0% and 20.3%, and 10.2% and 10.4%, respectively. The radiation dose received by patients in group B was less that in the group A (P<0.01). Conclusions: There is no significant difference in image quality between free-breathing and standard breath-holding CCTA. Free-breathing CCTA is an acceptable solution for patients with heart rate lower than 75 times per minute. |
Key words: coronary CT angiography heart rate free breathing breath-hold image quality |