摘要
目的应用双源CT前瞻性心电触发序列扫描对心房纤颤(atrial fibrillation,AF)患者行冠状动脉成像,并与回顾性心电门控螺旋扫描比较,评估二者的图像质量及放射剂量。方法对40例临床可疑冠心病的AF患者行二代128层双源CT增强扫描。随机分为两组:组1共21例(序列组),使用前瞻性心电触发序列扫描;组2共19例(螺旋组),使用回顾性心电门控螺旋扫描。基于AHA-15段冠状动脉分段法及4级评分法(1分-优秀至4分-差),由两位阅片者独立对所有冠状动脉按节段进行图像质量评价,比较两组患者的图像质量及有效放射剂量。结果序列组平均心率(94±25)次/min,心率波动(69±25)次/min;螺旋组平均心率(86±22)次/min,心率波动(65±22)次/min,组间平均心率(t=1.019,P=0.315)及心率波动(t=0.598,P=0.553)差异无统计学意义。序列组与螺旋组的图像质量优良,评分差异无统计学意义(1.29±0.55 vs 1.25±0.55;Z=-1.290,P=0.197);序列组的有效放射剂量较螺旋组显著降低(4.90±1.62 mSv vs 10.04±3.57 mSv;t=-5.988,P=0.000)。结论 AF患者双源CT冠状动脉成像中,前瞻性心电触发序列扫描与回顾性心电门控螺旋扫描相比,可以提供同样高质量的图像满足诊断需要,同时有效减低放射剂量。
Objective To evaluate the image quality （IQ） and radiation dose of 128-slice dual-source CT （DSCT） coronary angiography using prospectively electrocardiogram（ECG）-triggered sequential scan mode compared with ECG-ga- ted spiral scan mode in a population with atrial fibrillation （AF）. Methods Forty patients with suspected coronary artery disease （CAD） and permanent AF underwent second-generation 128-slice DSCT coronary angiography. 21 patients （se- quential group） were randomly selected to perform prospectively ECG-triggered sequential scan, while the other 19 patients （spiral group） performed retrospectively ECG-gated spiral scan. The IQ was assessed by two readers independently, using a four-point grading scale from excellent （ grade 1 ） to non-assessable （ grade 4）, based on the American Heart Association 15-segment model. IQ of each segment and effective dose of each patient were compared between the two groups. Results The mean heart rate （HR） of the sequential group was 94± 25 beats per minute （bpm） with a variation range of 69 ± 25 bpm, while the mean HR of the spiral group was 86 ± 22 with a variation range of 65 ± 22 bpm. Both of the mean HR （ t = 1. 019 ,P = 0.315 ） and HR variation range （ t = 0. 598 ,P = 0.533 ） had no significant difference between the two groups. Overall averaged IQ in sequential and spiral group showed equally good （1.29±0.55 vs 1.25 ±0.55 ,Z = -1. 290, P = 0. 197 ）. The effective radiation dose of the sequential group was reduced significantly compared with the spiral group （4.90±1.62 mSv vs 10.04 ±3.57 mSv; t= -5.988,P=0.000. Conclusion Compared with retrospectively ECG-ga- ted spiral scan, prospectively ECG-triggered sequential DSCT coronary angiography provides similarly diagnostically valua- ble images in patients with AF and significantly reduces radiation dose.
出处
《临床放射学杂志》
CSCD
北大核心
2012年第12期1719-1722,共4页
Journal of Clinical Radiology
