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国产新型320排CT冠状动脉成像的初步应用研究及图像质量评价

Application and image quality evaluation of new domestic 320-slice CT in coronary artery imaging

    摘要
  • 摘要:
    目的 我国自主研发的首台320排宽体探测器螺旋CT进入临床应用，本研究初步评估该新型CT在不同心率和心律条件下进行冠状动脉（冠脉）CT血管成像（coronary computed tomography angiography，CCTA）检查的成像质量和辐射剂量。
    方法 2020年5月11日至2020年6月19日共160例患者在该型CT行CCTA检查。将窦性心律者分为低心率组、中等心率组、高心率组，心律不齐者归为心律不齐组。对CCTA图像质量进行4级评分，依据分数判定优良，统计图像优秀率及优良率。比较不同心律及心率条件下冠脉近段、中段、远段的图像质量分布及有效辐射剂量。
    结果 窦性心率患者129例（低心率组40例、中等心率组57例、高心率组32例）及17例心律不齐患者纳入本研究，可评估的冠脉血管共计1 929段，可诊断率为99.79%，冠脉节段总体优秀率为47.0%，优良率为88.9%。4组患者冠脉图像的总体优良率分别为88.4%、89.4%、88.4%、89.7%，各组间差异无统计学意义。优秀率分别为48.2%、50.1%、45.8%、36.3%（P=0.004），其中心律不齐组的图像优秀率明显低于低心率组（P=0.003）、中等心率组（P=0.001）。随着冠脉分支由近及远，图像质量的优秀率和优良率明显下降。心律不齐组冠脉CTA与其他3组的有效吸收剂量差异有统计学意义（P < 0.001）。
    结论 该新型320排640层螺旋CT在不同心率及心律条件下均可获得满足临床诊断需求的图像，患者个体相关的心律及心率因素对冠脉图像的整体优良率无影响。

     

    Abstract:
    Objective The first 320-slice spiral CT independently developed in China had been approved for clinical application. In this study, this new CT equipment was used for coronary CT angiography (CCTA), and the imaging quality and radiation dose were preliminarily evaluated under different heart rate and cardiac rhythm conditions.
    Methods From May 11, 2020 to June 19, 2020, a total of 160 patients underwent CCTA using this type of CT. The patients with sinus rhythm were divided into low heart rate group, medium heart rate group, and high heart rate group, and patients with arrhythmias were classified into arrhythmia group. The image quality of CCTA was graded at 4 levels, and the excellent rate and good rate of the images were calculated according to the score. The image quality distribution and effective doses of the proximal, middle, and distal segments of the coronary arteries under different rhythm and rates were analyzed.
    Results 129 patients with normal heart rate (low heart rate group: 40 cases; medium heart rate group: 57 cases; high heart rate group: 32 patients) and 17 patients with arrhythmia were included in this study. Totally, 1 929 coronary artery segments were evaluated, and the diagnostic rate was 99.79%. The overall excellent rate of coronary segments was 47.0%, and the good rate was 88.9%. The overall excellent and good rates of coronary artery images in the four groups were 88.4%, 89.4%, 88.4%, and 89.7%, respectively, with no statistically significant difference among different groups. The excellent rates were 48.2%, 50.1%, 45.8%, and 36.3% (P=0.004), respectively, and the excellent rates in the arrhythmia group were significantly lower than those in the low heart rate group and the moderate heart rate group (P=0.003 and 0.001, respectively). With the coronary artery branches from proximal to distal, the excellent rate and good rate of image quality decrease significantly. The effective dose of arrhythmia group was significantly higher than those of the other three groups (P < 0.001).
    Conclusions The new 320-slice spiral CT can obtain images that meet clinical diagnostic requirements under different heart rate and cardiac rhythm conditions, and the heart rate and cardiac rhythm factors have no effect on the overall quality of coronary images.

     

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