时相选择结合追踪冻结技术在心率不齐患者心脏冠脉CTA中的应用
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摘要
目的探讨自动选择最佳时相功能结合冠脉运动追踪冻结技术重建血管图像在心率不齐患者心脏冠脉CCTA成像中的应用。方法筛选我院行冠脉CCTA检查时出现心律不齐的患者32例,所有患者采用Autogating推荐的时相区间获取单心动周期的图像数据。根据是否采用运动追踪冻结技术处理图像分为两组:A组,自动选择最佳时相使用STD算法重建图像;B组,在自动选择最佳时相并使用STD算法重建图像的基础上使用运动追踪冻结技术处理图像。测量主动脉根部的信噪比SNR并对图像进行主观质量评分,采用两样本配对设计比较的秩和检验比较图像质量。结果在A组32例患者128条主血管中,只有3条右冠状动脉不可诊断,其余的均可满足诊断的要求;B组中没有不可诊断血管。A、B两组图像的信噪比分别为14.45±3.41和14.48±3.43,差异无统计学意义(P=0.677)。A、B两组各主血管的图像质量评分:右冠状动脉:3.50±0.72和4.09±0.69,P=0.000;左冠状动脉主干:4.03±0.18和4.19±0.40,P=0.083;左回旋支:3.72±0.52和3.97±0.54,P=0.014;左前降支:3.96±0.35和4.03±0.47,P=0.655。B组中右冠及左回旋支的图像质量较A组显著提高,左主干和前降支的质量也有所改善。结论自动选择最佳时相结合冠脉运动追踪冻结技术重建血管在心律不齐患者冠脉CTA成像中具有可行性,能够重建出满足临床诊断的图像。
Objective To evaluate the effects of the Smart Phase function that automatically selects the optimal cardiac phase for reconstruction combined with a motion correction algorism(named Snap-Shoot Freeze, SSF) on improving image quality in the coronary CT angiography(CCTA) for arrhythmia patients. Methods Data of thirty patients with arrhythmia who underwent CCTA were enrolled. CCTA image raw data was obtained in single cardiac phase and the scanning window was selected based on the recommendation from Auto Gating. Images were reconstructed using the cardiac phase recommended by Smart Phase, with the application of SSF(group A) or with SSF(group B). The CT value and noise of the aortic arch root at the level of the left coronary artery were measured and the signal to noise ratio(SNR) was calculated. The main coronary artery scorings were performed independently. The artery image quality scores and SNR from the two groups were analyzed using the rank sum test. Results Three of 120 coronary arteries from group A could not meet the requirements of clinical diagnosis while all coronary arteries from group B could be diagnosed. The SNR of the aortic arch root were not different between the two groups(14.45±3.41 vs. 14.48±3.43, P=0.677). The image quality scores of right coronary artery(RCA), left main coronary artery(LM), left circumfl ex artery(LCX) and left anterior descending(LAD) from Group A were 3.44±0.75, 4.03±0.19, 3.71±0.52, 3.96±0.3, while the scores for group B were 4.08±0.70, 4.16±0.37, 3.96±0.54, 4.04±0.4. RCA and LCX from Group B were signifi cant higher than that of group A(P=0.000 and P=0.014), while there was no statistically difference between the groups in LM and LAD. SSF can signifi cantly improve RCA and LCX's image quality. Conclusion Smart Phase combined with SSF in the coronary CT angiography is feasible in patients with arrhythmia and can provide good quality images for clinical diagnosis.
Objective To evaluate the effects of the Smart Phase function that automatically selects the optimal cardiac phase for reconstruction combined with a motion correction algorism(named Snap-Shoot Freeze, SSF) on improving image quality in the coronary CT angiography(CCTA) for arrhythmia patients. Methods Data of thirty patients with arrhythmia who underwent CCTA were enrolled. CCTA image raw data was obtained in single cardiac phase and the scanning window was selected based on the recommendation from Auto Gating. Images were reconstructed using the cardiac phase recommended by Smart Phase, with the application of SSF(group A) or with SSF(group B). The CT value and noise of the aortic arch root at the level of the left coronary artery were measured and the signal to noise ratio(SNR) was calculated. The main coronary artery scorings were performed independently. The artery image quality scores and SNR from the two groups were analyzed using the rank sum test. Results Three of 120 coronary arteries from group A could not meet the requirements of clinical diagnosis while all coronary arteries from group B could be diagnosed. The SNR of the aortic arch root were not different between the two groups(14.45±3.41 vs. 14.48±3.43, P=0.677). The image quality scores of right coronary artery(RCA), left main coronary artery(LM), left circumfl ex artery(LCX) and left anterior descending(LAD) from Group A were 3.44±0.75, 4.03±0.19, 3.71±0.52, 3.96±0.3, while the scores for group B were 4.08±0.70, 4.16±0.37, 3.96±0.54, 4.04±0.4. RCA and LCX from Group B were signifi cant higher than that of group A(P=0.000 and P=0.014), while there was no statistically difference between the groups in LM and LAD. SSF can signifi cantly improve RCA and LCX's image quality. Conclusion Smart Phase combined with SSF in the coronary CT angiography is feasible in patients with arrhythmia and can provide good quality images for clinical diagnosis.
引文
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[17]王艳微,邢艳,刘文亚,等.冠状动脉CT成像中冠状动脉追踪冻结技术的价值[J].中国医学计算机成像杂志,2016,22(2):126-131.
[2]夏平,郝敬明,徐青松,等.高心率伴窦性心律不齐患者CT冠状动脉成像探讨[J].中华临床医师杂志:电子版,2013,(14):217-218.
[3]冯越,蔡国龙,李伟,等.双源CT低剂量适应性序列扫描对心律不齐冠状动脉成像的初步研究[J].解放军医学杂志,2013,38(4):320-323.
[4]李莉明,刘杰,高剑波.冠状动脉CT成像的个体化低对比剂剂量优化研究[J].临床放射学杂志,2016,35(12):1899-1903.
[5]郑超,汤连志,刘惠敏,等.CTA成像质量与造影剂注射速率相关性分析[J].中外医疗,2015,32(10):181-182.
[6]Oda S,Utsunomiya D,Yuki H,et al.Low contrast and radiation dose coronary CT angiography using a 320-row system and a refined contrast injection and timing method[J].J Cardiovasc Comput,2015,9(1):19-27.
[7]Lim K,Kwon H,Cho J,et al.Initial phantom study comparing image quality in computed tomography using adaptive statistical iterative reconstruction and new adaptive statistical iterative reconstruction v.[J].J Comput Assist Tomogr,2015,39(3):443-448.
[8]Benz DC,Gr?ni C,Mikulicic F,et al.Adaptive statistical iterative reconstruction-v:impact on image quality in ultralow-dose coronary computed tomography angiography[J].J Comput Assist Tomogr,2016,40(6):958-963.
[9]Sun G,Li M,Jiang XS,et al.320-detector row CT coronary angiography:effects of heart rate and heart rate variability on image quality,diagnostic accuracy and radiation exposure[J].Brit J Radiol,2012,85(1016):388-394.
[10]Matt D,Scheffel H,Leschka S,et al.Dual-source CT coronary angiography:image quality,mean heart rate,and heart rate variability[J].Am J Roentgenol,2012,189(3):567-573.
[11]Stassi D,Dutta S,Ma H,et al.Automated selection of the optimal cardiac phase for single-beat coronary CT angiography reconstruction[J].Medical Physics,2016,43(1):324.
[12]Stassi D,Dutta S,Ma H,et al.Automated selection of the optimal cardiac phase for single-beat coronary CT angiography reconstruction[J].Med Phys,2016,43(1):324.
[13]Zhou C,Chan HP,Hadjiyski LM,et al.Coronary artery analysis: Computer-assisted selection of best-quality segments in multiple-phase coronary CT angiography[J].Med Phys,2016,43(10):5268-5278.
[14]Fan L,Zhang J,Fu D,et al.Effect of snapshot freeze motion correction algorithm on image quality of retrospective ECGtriggered coronary CT angiography[A].Radiological Society of North America 2013 Scientifi c Assembly and Meeting[C].2013.
[15]高建生,陈晓霞,王贵生,等.智能冠状动脉运动追踪平台Snapshot Freeze在冠状动脉CT血管成像中的应用[J].中国医学影像技术,2014,30(12):1822-1826.
[16]Leipsic J,Labounty TM,Hague CJ,et al.Effect of a novel vendor-specifi c motion-correction algorithm on image qua lity and diagnostic accuracy in persons undergoing coronary CT angiography without rate-control medications[J].J Cardiovasc Comput,2012,6(3):164-172.
[17]王艳微,邢艳,刘文亚,等.冠状动脉CT成像中冠状动脉追踪冻结技术的价值[J].中国医学计算机成像杂志,2016,22(2):126-131.