单个心动周期CT冠状动脉成像在自由呼吸患者中应用的可行性
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摘要
目的比较自由呼吸及屏气呼吸两种状态下冠状动脉成像的图像质量,探讨320排CT对自由呼吸患者单个心动周期冠状动脉成像的可行性。资料与方法连续收集心率≤65次/min的140例患者,按随机数字表法分为A组(扫描时自由呼吸)和B组(严格进行屏气训练),每组70例。应用320排CT以前瞻性心电门控技术于单个心动周期行冠状动脉CT成像。对两组冠状动脉图像进行质量评价,并比较两种扫描条件下的辐射剂量。结果 1791个冠状动脉节段中,96.1%(1722/1791)能够满足诊断的图像质量要求。A、B两组图像质量可诊断率分别为95.3%(856/898)、97.0%(866/893),差异无统计学意义(P>0.05)。A、B两组有效辐射剂量分别为(2.1±0.9)m Sv、(1.9±0.7)m Sv,差异无统计学意义(P>0.05)。结论 320排CT在低心率患者自由呼吸时单个心动周期内完成冠状动脉成像检查具有可行性,能以较低的辐射剂量获得诊断所需图像。
Purpose To compare image quality of coronary artery imaging under free breathing and breath holding, and to explore the feasibility of 320-slice CT in single cardiac cycle coronary artery imaging for patients with free breathing. Materials and Methods A total of 140 patients with heart rate ≤ 65 beats per minutes were continuously collected and divided into group A(free breathing during scanning) and group B(strict breath holding training) as per random number table, with 70 patients in each group. Prospective ECGgating technique of 320-slice CT was applied in single cardiac cycle coronary artery CT imaging. The quality of coronary images of the two groups was evaluated and radiation doses under the two scanning conditions were compared. Results Of the 1791 coronary artery segments, 96.1%(1722/1791) were able to meet the image quality requirements for diagnosis. The diagnostic rate depending on image quality in groups A and B were 95.3%(856/898) and 97.0%(866/893) respectively, the difference of which was not statistically significant(P>0.05). The effective radiation doses of groups A and B were(2.1±0.9) mSv and(1.9±0.7) mSv, respectively, the difference of which was not statistically significant(P>0.05). Conclusion 320-slice CT is feasible for completing coronary artery imaging within a single cardiac cycle during free breathing of patients with low heart rate. The images needed for diagnosis can be obtained at a relatively less radiation doses.
Purpose To compare image quality of coronary artery imaging under free breathing and breath holding, and to explore the feasibility of 320-slice CT in single cardiac cycle coronary artery imaging for patients with free breathing. Materials and Methods A total of 140 patients with heart rate ≤ 65 beats per minutes were continuously collected and divided into group A(free breathing during scanning) and group B(strict breath holding training) as per random number table, with 70 patients in each group. Prospective ECGgating technique of 320-slice CT was applied in single cardiac cycle coronary artery CT imaging. The quality of coronary images of the two groups was evaluated and radiation doses under the two scanning conditions were compared. Results Of the 1791 coronary artery segments, 96.1%(1722/1791) were able to meet the image quality requirements for diagnosis. The diagnostic rate depending on image quality in groups A and B were 95.3%(856/898) and 97.0%(866/893) respectively, the difference of which was not statistically significant(P>0.05). The effective radiation doses of groups A and B were(2.1±0.9) mSv and(1.9±0.7) mSv, respectively, the difference of which was not statistically significant(P>0.05). Conclusion 320-slice CT is feasible for completing coronary artery imaging within a single cardiac cycle during free breathing of patients with low heart rate. The images needed for diagnosis can be obtained at a relatively less radiation doses.
引文
[1]祝小莲,李文欢,王慧霞,等.双源CT冠状动脉成像:320 mg I/ml替代370 mg I/ml对比剂的可行性.中国医学影像学杂志,2016,24(3):187-190.
[2]王丽君,王莉,王道萍,等.呼吸屏气训练对冠状动脉CTA成像质量的研究.医学影像学杂志,2014,24(5):723-725.
[3]梁奕,杜柏林,汪汉林,等.低浓度对比剂联合低电压和迭代重建算法在320排CT冠状动脉成像中的应用.实用放射学杂志,2016,32(1):114-117.
[4]温泽迎,王道清,杨中杰,等.糖尿病患者冠状动脉粥样硬化的双源CT分析.实用放射学杂志,2012,28(12):1891-1894.
[5]Tomizawa N,Yamamoto K,Akahane M,et al.The feasibility of halfcycle reconstruction in high heart rates in coronary CTangiography using 320-row CT.Int J Cardiovasc Imaging,2013,29(4):907-911.
[6]Tomizawa N,Komatsu S,Akahane M,et al.Influence of hemodynamic parameters on coronary artery attenuation with 320-detector coronary CT angiography.Eur J Radiol,2012,81(2):230-233.
[7]Kang EJ,Lee J,Lee KN,et al.An initial randomised study assessing free-breathing CCTA using 320-detector CT.Eur Radiol,2013,23(5):1199-1209.
[8]潘宇宁,李爱静,陈晓敏,等.低浓度等渗对比剂联合低管电压在肥胖患者冠状动脉成像中的应用.中华放射医学与防护杂志,2016,36(1):67-73.
[9]中华医学会放射学分会心胸学组.心脏冠状动脉CT血管成像技术规范化应用中国指南.中华放射学杂志,2017,51(10):732-743.
[10]Boussuges A,Gole Y,Blanc P.Diaphragmatic motion studied by m-mode ultrasonography:methods,reproducibility,and normal values.Chest,2009,135(2):391-400.
[11]Mao SS,Lu B,Oudiz RJ,et al.Coronary artery motion in electron beam tomography.J Comput Assist Tomogr,2000,24(2):253-258.
[12]Tomizawa N,Komatsu S,Akahane M,et al.Relationship between beat to beat coronary artery motion and image quality in prospectively ECG-gated two heart beat 320-detector row coronary CT angiography.Inte J Cardiovasc Imaging,2012,28(1):139-146.
[13]Pasricha SS,Nandurkar D,Seneviratne SK,et al.Image quality of coronary 320-MDCT in patients with atrial fibrillation:initial experience.Am J Roentgenol,2009,193(6):1514-1521.
[14]Goo HW,Yang DH.Coronary artery visibility in freebreathing young children with congenital heart disease on cardiac 64-slice CT:dual-source ECG-triggered sequential scan vs.single-source non-ECG-synchronized spiral scan.Pediatr Radiol,2010,40(10):1670-1680.
[15]江杰,谢晓洁,吴莉,等.双源CT低管电压结合迭代重建评估冠状动脉支架成像的可行性.中国医学影像学杂志,2015,23(4):289-292.
[16]Bischoff B,Meinel FG,Del Prete AA,et al.High-pitch coronary CT angiography in dual-source CT during free breathing vs.breath holding in patients with low heart rates.Eur J Radiol,2013,82(12):2217-2221.
[2]王丽君,王莉,王道萍,等.呼吸屏气训练对冠状动脉CTA成像质量的研究.医学影像学杂志,2014,24(5):723-725.
[3]梁奕,杜柏林,汪汉林,等.低浓度对比剂联合低电压和迭代重建算法在320排CT冠状动脉成像中的应用.实用放射学杂志,2016,32(1):114-117.
[4]温泽迎,王道清,杨中杰,等.糖尿病患者冠状动脉粥样硬化的双源CT分析.实用放射学杂志,2012,28(12):1891-1894.
[5]Tomizawa N,Yamamoto K,Akahane M,et al.The feasibility of halfcycle reconstruction in high heart rates in coronary CTangiography using 320-row CT.Int J Cardiovasc Imaging,2013,29(4):907-911.
[6]Tomizawa N,Komatsu S,Akahane M,et al.Influence of hemodynamic parameters on coronary artery attenuation with 320-detector coronary CT angiography.Eur J Radiol,2012,81(2):230-233.
[7]Kang EJ,Lee J,Lee KN,et al.An initial randomised study assessing free-breathing CCTA using 320-detector CT.Eur Radiol,2013,23(5):1199-1209.
[8]潘宇宁,李爱静,陈晓敏,等.低浓度等渗对比剂联合低管电压在肥胖患者冠状动脉成像中的应用.中华放射医学与防护杂志,2016,36(1):67-73.
[9]中华医学会放射学分会心胸学组.心脏冠状动脉CT血管成像技术规范化应用中国指南.中华放射学杂志,2017,51(10):732-743.
[10]Boussuges A,Gole Y,Blanc P.Diaphragmatic motion studied by m-mode ultrasonography:methods,reproducibility,and normal values.Chest,2009,135(2):391-400.
[11]Mao SS,Lu B,Oudiz RJ,et al.Coronary artery motion in electron beam tomography.J Comput Assist Tomogr,2000,24(2):253-258.
[12]Tomizawa N,Komatsu S,Akahane M,et al.Relationship between beat to beat coronary artery motion and image quality in prospectively ECG-gated two heart beat 320-detector row coronary CT angiography.Inte J Cardiovasc Imaging,2012,28(1):139-146.
[13]Pasricha SS,Nandurkar D,Seneviratne SK,et al.Image quality of coronary 320-MDCT in patients with atrial fibrillation:initial experience.Am J Roentgenol,2009,193(6):1514-1521.
[14]Goo HW,Yang DH.Coronary artery visibility in freebreathing young children with congenital heart disease on cardiac 64-slice CT:dual-source ECG-triggered sequential scan vs.single-source non-ECG-synchronized spiral scan.Pediatr Radiol,2010,40(10):1670-1680.
[15]江杰,谢晓洁,吴莉,等.双源CT低管电压结合迭代重建评估冠状动脉支架成像的可行性.中国医学影像学杂志,2015,23(4):289-292.
[16]Bischoff B,Meinel FG,Del Prete AA,et al.High-pitch coronary CT angiography in dual-source CT during free breathing vs.breath holding in patients with low heart rates.Eur J Radiol,2013,82(12):2217-2221.
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