摘要
目的:探讨第3代双源CT非心电门控技术在高心率先天性心脏病(先心病)患儿中的应用价值。方法:收集经胸超声心动图诊断的先心病患儿132例,心率均≥90次/min。使用Siemens第3代双源CT扫描仪Somatom Force行心脏CTA扫描,其中80例行非心电门控依赖性心脏CTA扫描(非心电门控组),52例行前瞻性心电门控依赖性心脏CTA扫描(前瞻性心电门控组)。记录2组患儿的性别、年龄、体质量、心率、容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP),并计算其有效辐射剂量(ED)。由2名副主任医师采用双盲法阅片,并对图像质量进行评分,评分一致性行Kappa检验。结果:前瞻性心电门控组管电流平均值(55.85±3.47)mAs,CTDIvol平均值(2.45±0.24)mGy,DLP平均值(46.16±5.20)mGy·cm,ED平均值(1.51±1.31)mSv;非心电门控组管电流平均值(47.83±2.86)mAs,CTDIvol平均值(0.60±0.31)mGy,DLP平均值(10.22±0.64)mGy·cm,ED平均值(0.36±0.20)mSv,2组差异均有统计学意义(均P<0.05)。在心外结构及心房、心室壁的显示上,2种检查方法均能够获得较好的图像,评分多在4分以上,差异无统计学意义(P>0.05);2种扫描方法对冠状动脉显示均欠佳,多在3分以下,多无法满足诊断需要。结论:高心率先心病患儿采用非心电门控依赖性心脏CTA扫描技术可在保证良好图像质量的前提下显著降低辐射剂量,具有较好的临床应用前景。
Objective:To explore the application value of the third-generation dual-source CT non-ECG-gated technique in children with high heart rate and complex congenital heart disease.Methods:A collection of 132 children with congenital heart disease diagnosed by transthoracic echocardiography with a heart rate of≥90 bpm.All children used Siemens third-generation dual-source CT scanner Somatom Force to perform cardiac CTA scanning.Among them,80 children used non-ECG-gated-dependent cardiac CTA scanning,and 52 cases used prospective ECG-gated-dependent cardiac CTA scaning.The gender,age,weight,heart rate,volume CT dose index(CTDIvol),dose length product(DLP)were recorded,and the effective radiation dose(ED)was calculated.All pictures were read by two deputy chief physicians using a double-blind method,and the quality of the pictures were scored.Results:The average value of tube current in the prospective ECG gating group was(55.85±3.47)mAs,the average CTDIvol was(2.45±0.24)mGy,the average DLP was(46.16±5.20)mGy·cm,the average ED was(1.51±1.31)mSv.The average tube current in the non-ECG-gating group was(47.83±2.86)mAs,and the average CTDIvol was(0.60±0.31)mGy,the average value of DLP was(10.22±0.64)mGy·cm,and the average ED was(0.36±0.20)mSv.There were statistical significances between the two groups.In the display of extracardiac structures and atrium and ventricular walls,both inspection methods could obtain better images,and the score was more than 4 points,there was no statistical difference(P<0.05).Both scanning methods showed poor coronary arteries,mostly below 3 points,which could not meet the needs of diagnosis.Conclusions:Children with high heart rate congenital heart disease can obtain high-quality images by using non-ECG gate-dependent cardiac CTA scanning,at the same time the radiation dose is significantly reduced,and it has a good prospect of clinical application.
作者
张士朋
谢一婧
王雁南
姚红艳
陈晓飞
周晟
ZHANG Shipeng;XIE Yijing;WANG Yannan;YAO Hongyan;CHEN Xiaofei;ZHOU Sheng(不详;Department of Radiology,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China)
出处
《中国中西医结合影像学杂志》
2022年第2期176-181,共6页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
