协和医学杂志

2012, (02)

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双源CT冠状动脉成像中前瞻性与回顾性心电触发模式的比较
Comparison of Prospective and Retrospective Electrocardiogram-triggered in Coronary CT Angiography using Dual-source CT

樊红苓;金征宇;孔令燕;李烁;王明;王怡宁;王志伟;周慷

摘要(Abstract):

目的 比较前瞻性心电触发序列扫描与与回顾性螺旋扫描模式在双源CT冠状动脉成像中的图像质量及放射线剂量。方法 将70例临床怀疑或已知冠心病患者随机分为两组,分别行前瞻性心电触发序列扫描(A组)与回顾性螺旋扫描(B组)冠状动脉CT成像,分别对两种成像模式的图像质量及放射线剂量进行评价。结果 两组患者的临床资料(组成、年龄、体重指数)匹配性良好,差异无统计学意义。两组的图像质量评分差异有统计学意义,分别为1.13±0.36和1.04±0.24(Z =-5.073,P =0.00),两组可评价的冠状动脉节段显示率分别为99.62%和99.62%,差异无统计学意义(χ2=0.00,P=1.00)。前瞻性心电触发序列扫描模式的放射线剂量(3.47±1.00)mSv明显低于回顾性螺旋扫描模式(14.28±1.81)mSv,两组差异具有统计学意义(P =0.032)。结论 对于心律齐且心率≤70次/min的患者,尽管前瞻性心电序列扫描的图像质量略差于回顾性螺旋扫描模式,但两者可评价的冠状动脉节段显示率无明显差异,而前者的有效放射剂量明显减少。
Objective To compare the image quality and radiation exposure of prospectively electrocardiogram (ECG)-triggered sequential and retrospectively spiral acquisition coronary CT angiography by dual-source CT. Methods Seventy patients with suspected or known coronary artery disease were randomly divided into two groups. Group A underwent prospective ECG-triggering sequential scan and group B performed retrospective ECG-triggering spiral scan. Both the image quality and radiation exposure of the two modes were evaluated. Results There was no remarkable difference in age and body mass index of the two groups. The average image quality score was 1.13±0.36 in Group A and 1.04±0.24 in group B. Statistical difference was found between the two groups(Z =-5.073,P =0.00). The rates of diagnostic coronary segments for two groups were 99.62% and 99.62%, respectively (χ2=0.00,P=1.00). The mean effective dose of group A was significantly lower than that of group B [(3.47±1.00) mSv vs. (14.28±1.81) mSv;P=0.032]. Conclusion The prospective ECG-triggered sequential scan coronary CT angiography technique significantly reduces radiation dose without impairing the rates of diagnostic coronary segments when compared with the retrospective ECG-triggered spiral data acquisition in patients with a low and stable heart rate (< 70bpm).

关键词(KeyWords): |冠状动脉成像|X线计算机体层摄影术|影像质量|放射剂量|
|coronary angiography| X - ray computed tomography| image quality| radiation exposure|

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作者(Author): 樊红苓;金征宇;孔令燕;李烁;王明;王怡宁;王志伟;周慷

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