摘要
目的研究双源CT低剂量适应性序列扫描技术在心律不齐患者冠状动脉CT血管造影(CTA)中的应用,并评价其诊断准确性。方法 2009年1月-2010年12月在浙江医院行双源CTA检查的心律不齐患者134例,根据扫描方式不同分为A组(行常规回顾性心电门控螺旋扫描,n=78)和B组(行适应性序列扫描,n=56)。以传统冠状动脉造影为金标准,计算双源CT冠状动脉CTA的敏感性、特异性、阳性预测值、阴性预测值并进行组间比较,同时分析比较两组患者的辐射剂量差异。结果 A组诊断冠状动脉整体≥50%狭窄的敏感性、特异性、阳性预测值、阴性预测值分别为97.0%、98.5%、87.4%、99.7%,而B组分别为97.0%、98.8%、88.9%、99.7%,组间比较差异无统计学意义(P>0.05)。A组的有效剂量为12.0±3.6mSv,明显高于B组(3.1±0.7mSv),差异有统计学意义(Z=–9.826,P=0.00)。结论心律不齐患者进行CTA检查时,应用双源CT适应性序列扫描结合绝对时相重建可获得良好的图像质量及较高的诊断准确性,并可降低辐射剂量。
Objective To investigate the application of low-dose adaptive sequence scan of dual-source CT in coronary angiography of patients with arrhythmia, and evaluate its diagnostic accuracy. Methods One hundred and thirty-four patients with arrhythmia undergoing dual-source CT coronary angiography （CTA） were divided into 2 groups according to the scan mode： patients in group A underwent retrospective ECG-gating helical scanning （n=78）; patients in group B received adaptive sequence scanning （n=56）. The sensitivity, specificity, and positive and negative predictive values of dual-source CTA were determined by using conventional coronary angiography as the reference standard. The significance of difference between the two groups was analyzed, and the respective radiation dose was also compared. Results The overall sensitivity, specificity, and positive and negative predictive values was 97.0%, 98.5%, 87.4% and 99.7%, respectively in group A, and 97.0%, 98.8%, 88.9% and 99.7%, respectively, in group B. No statistical difference was found between two groups （P〉0.05）. The average effective radiation dose was 12.0 ＋ 3.6mSv in group A, which was significantly higher than that in group B （3.1 ＋ 0.7mSv, Z=-9.826, P=0.00）. Conclusion Adaptive sequence scan combined with the absolute phase reconstruction in dual-source CT coronary angiography is feasible in patients with arrhythmia in providing good image quality and diagnostic accuracy at a low effective radiation dose.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2013年第4期320-323,共4页
Medical Journal of Chinese People's Liberation Army
