中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2010年
1期
48-52
,共5页
唐翔%吕滨%韩磊%白桦%鲁锦国%陈雄彪%王宏宇%杨新令%吴言伶%侯志辉%戴汝平%蒋世良
唐翔%呂濱%韓磊%白樺%魯錦國%陳雄彪%王宏宇%楊新令%吳言伶%侯誌輝%戴汝平%蔣世良
당상%려빈%한뢰%백화%로금국%진웅표%왕굉우%양신령%오언령%후지휘%대여평%장세량
心脏缺损,先天性%儿童%冠状血管%体层摄影术,X线计算机
心髒缺損,先天性%兒童%冠狀血管%體層攝影術,X線計算機
심장결손,선천성%인동%관상혈관%체층섭영술,X선계산궤
Heart defects,ongential%Child%Coronary vessels%Tomography,X-ray computed
目的 分析儿童先天性心脏病双源CT(DSCT)扫描对冠状动脉显示的效果.方法 2名放射科医师分别对儿童先天性心脏病DSCT扫描的图像评分,按冠状动脉各分支成像效果评为1～4分,3分以上为成像质量较好,可以用于诊断.采用方差分析比较3个心率水平、3个年龄段下冠状动脉评分差异及4支冠状动脉分支间评分差异.采用多元线性回归分析比较各支冠状动脉评分与年龄、心率、管电压、管电流、螺距、对比剂总量、对比剂流率的关系.结果 共评价72例患儿(平均1.5岁),71.2%(205/288)的冠状动脉分支图像质量较好,可以用于诊断.左主干(3.64±0.49)分、前降支(2.97±0.40)分、右冠状动脉(2.82±0.70)分、回旋支(2.76±0.73)分,各支评分依次降低而不完全相同(F=29.00,P<0.01).<1岁组(2.80±0.65)分、≥1～3岁组(2.81±0.74)分、>3～14岁组(3.58±0.52)分,各组评分依次升高而不完全相同(F=20.16,P<0.01).心率<100次/min(bpm)组(3.54±0.56)分,100～150 bpm组(2.86±0.70)分,>150 bpm组(2.81±0.63)分,各组评分依次降低而不完全相同(F=16.72,P<0.01).多元回归分析显示年龄(r=0.013,P<0.01)和对比剂总量(r=0.292,P=0.011)与左主干评分呈正相关;年龄(r=0.509,P<0.01)、管电压与前降支评分呈正相关(r=0.292,P<0.01),心率与前降支评分呈负相关(r=-0.179,P<0.05);年龄与回旋支评分呈负相关(r=0.063,P<0.01);年龄、管电压与右冠状动脉评分呈正相关(r值分别为0.486、0.220,P值分别<0.01、<0.05).结论 DSCT能够清晰显示3岁以上或心率<100 bpm的先天性心脏病儿童的冠状动脉,限制DSCT成像效果的是患儿的基础心律和年龄.
目的 分析兒童先天性心髒病雙源CT(DSCT)掃描對冠狀動脈顯示的效果.方法 2名放射科醫師分彆對兒童先天性心髒病DSCT掃描的圖像評分,按冠狀動脈各分支成像效果評為1～4分,3分以上為成像質量較好,可以用于診斷.採用方差分析比較3箇心率水平、3箇年齡段下冠狀動脈評分差異及4支冠狀動脈分支間評分差異.採用多元線性迴歸分析比較各支冠狀動脈評分與年齡、心率、管電壓、管電流、螺距、對比劑總量、對比劑流率的關繫.結果 共評價72例患兒(平均1.5歲),71.2%(205/288)的冠狀動脈分支圖像質量較好,可以用于診斷.左主榦(3.64±0.49)分、前降支(2.97±0.40)分、右冠狀動脈(2.82±0.70)分、迴鏇支(2.76±0.73)分,各支評分依次降低而不完全相同(F=29.00,P<0.01).<1歲組(2.80±0.65)分、≥1～3歲組(2.81±0.74)分、>3～14歲組(3.58±0.52)分,各組評分依次升高而不完全相同(F=20.16,P<0.01).心率<100次/min(bpm)組(3.54±0.56)分,100～150 bpm組(2.86±0.70)分,>150 bpm組(2.81±0.63)分,各組評分依次降低而不完全相同(F=16.72,P<0.01).多元迴歸分析顯示年齡(r=0.013,P<0.01)和對比劑總量(r=0.292,P=0.011)與左主榦評分呈正相關;年齡(r=0.509,P<0.01)、管電壓與前降支評分呈正相關(r=0.292,P<0.01),心率與前降支評分呈負相關(r=-0.179,P<0.05);年齡與迴鏇支評分呈負相關(r=0.063,P<0.01);年齡、管電壓與右冠狀動脈評分呈正相關(r值分彆為0.486、0.220,P值分彆<0.01、<0.05).結論 DSCT能夠清晰顯示3歲以上或心率<100 bpm的先天性心髒病兒童的冠狀動脈,限製DSCT成像效果的是患兒的基礎心律和年齡.
목적 분석인동선천성심장병쌍원CT(DSCT)소묘대관상동맥현시적효과.방법 2명방사과의사분별대인동선천성심장병DSCT소묘적도상평분,안관상동맥각분지성상효과평위1～4분,3분이상위성상질량교호,가이용우진단.채용방차분석비교3개심솔수평、3개년령단하관상동맥평분차이급4지관상동맥분지간평분차이.채용다원선성회귀분석비교각지관상동맥평분여년령、심솔、관전압、관전류、라거、대비제총량、대비제류솔적관계.결과 공평개72례환인(평균1.5세),71.2%(205/288)적관상동맥분지도상질량교호,가이용우진단.좌주간(3.64±0.49)분、전강지(2.97±0.40)분、우관상동맥(2.82±0.70)분、회선지(2.76±0.73)분,각지평분의차강저이불완전상동(F=29.00,P<0.01).<1세조(2.80±0.65)분、≥1～3세조(2.81±0.74)분、>3～14세조(3.58±0.52)분,각조평분의차승고이불완전상동(F=20.16,P<0.01).심솔<100차/min(bpm)조(3.54±0.56)분,100～150 bpm조(2.86±0.70)분,>150 bpm조(2.81±0.63)분,각조평분의차강저이불완전상동(F=16.72,P<0.01).다원회귀분석현시년령(r=0.013,P<0.01)화대비제총량(r=0.292,P=0.011)여좌주간평분정정상관;년령(r=0.509,P<0.01)、관전압여전강지평분정정상관(r=0.292,P<0.01),심솔여전강지평분정부상관(r=-0.179,P<0.05);년령여회선지평분정부상관(r=0.063,P<0.01);년령、관전압여우관상동맥평분정정상관(r치분별위0.486、0.220,P치분별<0.01、<0.05).결론 DSCT능구청석현시3세이상혹심솔<100 bpm적선천성심장병인동적관상동맥,한제DSCT성상효과적시환인적기출심률화년령.
Objective To analyze the image quality of coronary arteries by dual-source computed tomography (DSCT) in children with congenital heart disease(CHD). Methods Image quality of coronary arteries were scored by two radiologists with an ordinal grading system. Score 3 or 4 was considered to be good image quality and diagnostic. Score differences among 3 groups of various baseline heart rate levels, 3 groups of various age levels and 4 coronary branches were analyzed by using ANOVA. Multiple linear regression analysis was used to test the effects of age, heart rate, tube voltage, tube current, pitch, contrast volume, contrast injection rate on the coronary image scores. Results A total of 72 consecutive patients were enrolled. 71.2% (205/288) of coronary artery branches was good enough for diagnosis. Image quality of left main coronary artery (LM, score 3.64±0.49), left anterior descending (LAD, score 2.97±0.40), right coronary artery (RCA, score of 2.82±0.70), left circumflex (LCX, score 2.76±0.73) were in a descending order (F=29.00, P<0.01). Image scores of age groups of 0--1 years old (2.80±0.65), >1--3 years old (2.81±0.74), >3--14 years old (3.58±0.52) were in an ascending order (F= 20.16,P<0.01). Image scores of heart rate groups of<100 bpm (3.54±0.56),100--150 bpm (2.86± 0.70) and >150 bpm (2.81±0.63) were in a descending order (F=16.72, P<0.01). Multiple linearregression analysis demonstrated that multiple impact factors affected image quality of LM, LAD, LCX and RCA. Age(r=0.013 ,P<0.01)and contrast volume(r=0.292, P<0.01)had positive correlation with LM score. Age(r=0.509, P<0.01) and voltage (r=0.292, P=0.011) had positive correlation with LAD score. Heart rate(r= -0.179, P<0.05) had negative correlation with LAD score. Age (r=0.063, P< 0.01) had negative correlation with LCX score. Age (r=0.486,P<0.01) and voltage (r=0.220, P<0.05) had positive correlation with RCA score. Conclusions Dual-source CT could clearly shows coronary arteries of children with CHD over the age of 3 or with heart rate less than 100 bpm. Limitations of Dual-source CT coronary angiography for CHD children included young age and fast heart rate.
