摘要
目的评价心率对急性胸痛患者行320排640层动态容积CT胸痛三联检查图像质量及辐射剂量的影响。方法回顾性分析2011年3月15日至9月15日河北沧州市中心医院38例急性胸痛患者的临床及影像资料。全部患者均接受了320排640层动态容积CT检查。扫描方案为心电门控下全胸部螺旋扫描（160×0．5mm）。按心率不同将患者分为A、B两组（A组18例，心率≤65次／min；B组20例，心率〉65次／min），分别评价A、B组间肺动脉、主动脉及冠状动脉图像质量及辐射剂量，冠状动脉主观质量评价分优、良、可、差4级。结果（1）总体质量评价：升主动脉根部、主肺动脉、右冠状动脉及左冠状动脉平均CT值分别为（412．4-79）HU、（381±107）HU、（408±79）HU、（4064-79）HU；升主动脉根部对比噪声比（CNR）为124-7；冠状动脉主观评价质量优的阶段占66．13％，良＋可占32．79％，差占1．08％。平均辐射剂量为（22±3）mSv。（2）A、B两组间升主动脉根部、主肺动脉、右冠状动脉及左冠状动脉平均CT值、升主动脉根部CNR分别为（421±62）HU比（4044-93）HU、（4024-103）HU比（3624-110）HU、（417±62）HU比（400±92）HU、（4174-63）HU比（3974-92）HU、104-3比134-8，差异均无统计学意义（均P〉0．05）。A、B两组间冠状动脉主观评价质量优的节段数和可评价节段数（优＋良＋可节段数）均有统计学差异（P=0．001，0．019），A组优于B组，但B组可诊断节段数仍达97．9％。A、B两组间辐射剂量分别为（184-6）mSv比（264-5）mSv，差异有统计学意义（P=0．000），B组明显高于A组。结论320排640层动态容积CT胸痛三联检查，无论高低心率组，均可获得高质量的主动脉、肺动脉和冠状动脉图像，对比剂用量和患者辐射剂量较低。适用于急性胸痛病因诊断。降低心率可进一步提高冠状动脉图像质量并减少辐射剂量。
Objective To evaluate the effects of heart rate （HR） on image quality and radiation dose of ＂triple rule-out＂ 320-row-640-slice multidetector computed tomography （MDCT） scan in patients with acute chest pain. Methods Retrospective analyses were performed for the clinical and imaging data of 38 cases with acute chest pain. All patients received 320-row-640-sliee MDCT. Scanning program was electrocardiography-gated helical scan of full chest （160 x 0. 5 mm）. Based upon different heart rates, they were divided into A and B groups （ A ： n = 18, HR ≤ 65 bpm ; B ： n = 20, HR 〉 65 bpm）. The results of image quality and radiation dose of pulmonary artery, aorta and coronary artery between A and B group were evaluated respectively. The subjective quality indicators of coronary artery were excellent, good, qualified and poor. Results （ 1 ） Overall quality assessment： the mean CT values of ascending aortic root, main pulmonary artery, right coronary artery and left coronary artery were （412 ± 79 ） HU, （381 ± 107 ） HU, （408 ± 79） HU, （406 ± 79） HU respectively; the contrast-noise ratio （CNR） of ascending aorta root was 12 ±7; excellent stage of subjective quality assessment of coronary artery accounted for 66. 13%, good and qualified stage 32. 79% and poor stage 1.08%. The mean radiation dose was 22±3 mSv. （2）The mean CT value between A and B groups of ascending aortic root, main pulmonary artery, right coronary artery and leftcoronary artery, and C NR of ascending aortic root [ （421 ± 62） HU vs （404 ± 93 ） HU, （402 ±103） HU vs （362 ± 110） HU, （417 ± 62） HU vs （400 ±92） HU, （417 ± 63） HU vs （397 ± 92） HU, 10 ± 3 vs 13 ± 8 respectively] were not statistically different （P 〉 0. 05 ）; the number of segments of excellent subjective quality assessment and evaluable （ excellent, good and qualified） of coronary artery between A and B groups were statistically significant （P =0. 001, P =0. 019）. Group A was better
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第37期2652-2655,共4页
National Medical Journal of China
关键词
体层摄影术
X线
胸痛
心率
Tomography, X-ray
Chest pain
Heart rate
