CAJ | 학술논문

目的初步探讨应用320层CT心电门控双期心功能扫描模式(DPCFA)一站式评价心脏、冠状动脉、肺动脉形态及左、右心室功能的能力.方法回顾性分析40例经临床确诊患者的320层CT DPCFA扫描数据,分别以肺动脉期重建并观察肺动脉分支,以主动脉期重建并观察冠状动脉.分别以两期数据进行MPR重组并分析左、右心室功能,结果与超声心动图相对照.5例因图像质量欠佳排除组外,35例图像质量达到2级以上,可用作诊断,扫描平均心率(71.2±11.2)次/min,全部患者扫描期间未出现心律失常.应用Pearson检验进行相关性分析,应用配对t检验分析二者测量左心室射血分数(LVEF)的一致性.结果 (1)35例最终入组患者中,诊断单发肺动脉栓塞l1例,冠心病支架术后7例,单发冠心病5例,先天性心脏病房间隔缺损3例,特发性肺动脉高压3例,左房黏液瘤l例,肺动脉栓塞合并冠心病5例,全部符合临床诊断.(2)CT与超声心动图对照,35例患者的左、右心室舒张末期最大径分别为(36.7±3.3)、(43.3±3.4)mm,左、右心室收缩末期最大径分别为(31.6 ±5.1)、(41.3±5.1)mm,LVEF为47.1±15.1.超声心动图测得左、右心室舒张末期最大径分别为(40.3±3.1)、(47.3±4.2)mm,左、右心室收缩末期最大径分别为(37.3±5.6)、(45.3±3.3)mm,LVEF为46.0±14.8.CT与超声测量结果有显著的相关性(r=0.886～0.988,P值均＜0.01),LVEF的测量结果差异无统计学意义(t=0.692,P＞0.05).(3)应用DPCFA技术,平均射线剂量(5.4 ±0.5)mSv.结论 320层CT心电门控双期心功能扫描模式,可以用于心血管疾病一站式影像检查,可为临床心血管疾病的诊断、鉴别诊断、治疗方案的确定提供丰富的影像学信息,对左、右心功能不全相关临床问题的处理具有指导作用.
목적 초보탐토응용320층CT심전문공쌍기심공능소묘모식(DPCFA)일참식평개심장、관상동맥、폐동맥형태급좌、우심실공능적능력.방법 회고성분석40례경림상학진환자적320층CT DPCFA소묘수거,분별이폐동맥기중건병관찰폐동맥분지,이주동맥기중건병관찰관상동맥.분별이량기수거진행MPR중조병분석좌、우심실공능,결과여초성심동도상대조.5례인도상질량흠가배제조외,35례도상질량체도2급이상,가용작진단,소묘평균심솔(71.2±11.2)차/min,전부환자소묘기간미출현심률실상.응용Pearson검험진행상관성분석,응용배대t검험분석이자측량좌심실사혈분수(LVEF)적일치성.결과 (1)35례최종입조환자중,진단단발폐동맥전새l1례,관심병지가술후7례,단발관심병5례,선천성심장병방간격결손3례,특발성폐동맥고압3례,좌방점액류l례,폐동맥전새합병관심병5례,전부부합림상진단.(2)CT여초성심동도대조,35례환자적좌、우심실서장말기최대경분별위(36.7±3.3)、(43.3±3.4)mm,좌、우심실수축말기최대경분별위(31.6 ±5.1)、(41.3±5.1)mm,LVEF위47.1±15.1.초성심동도측득좌、우심실서장말기최대경분별위(40.3±3.1)、(47.3±4.2)mm,좌、우심실수축말기최대경분별위(37.3±5.6)、(45.3±3.3)mm,LVEF위46.0±14.8.CT여초성측량결과유현저적상관성(r=0.886～0.988,P치균＜0.01),LVEF적측량결과차이무통계학의의(t=0.692,P＞0.05).(3)응용DPCFA기술,평균사선제량(5.4 ±0.5)mSv.결론 320층CT심전문공쌍기심공능소묘모식,가이용우심혈관질병일참식영상검사,가위림상심혈관질병적진단、감별진단、치료방안적학정제공봉부적영상학신식,대좌、우심공능불전상관림상문제적처리구유지도작용.
Objective To explore the feasibility of evaluating cardiac structure, coronary artery,pulmonary artery and cardiac function in one single scan by 320-row CT ECG-gated double phase cardiac function scan mode. MethodsForty patients underwent the 320-detector row CT double phase cardiovascular angiography. The pulmonary phase and aortic phase were reconstructed in order to evaluate the pulmonary and coronary artery. MPR reconstructions of both pulmonary and aortic phase were used to analyze the function of the two ventricles. And the results of the cardiac function were compared with those of transthoracic echocardiography. Thirty-five cases could be analyzed and diagnosed, while the other 5 cases had to be given up because of the poor imaging quality. The mean heart rate was (71.2 ± 11.2) beat per min (bpm). No arrhythmia case included. Results ( 1 ) Pulmonary embolism were diagnosed in 11 cases,coronary artery disease (CAD) were found in 5 cases, while post-stent implantation were observed in 7 cases. Six cases of congenital heart disease were diagnosed with 3 ASD and 3 primary pulmonary hypertension. Another one was diagnosed with left atrial myxoma, and 5 cases were pulmonary embolism associated with CAD. All of above cases were verified by final clinical diagnosis. (2) The heart function parameters including LVEDd , RVEDd, LVESd, RVESd and LVEF were (36.7 ±3.3), (43.3 ± 3.4) mm,(31.6±5.1), (41.3 ±5.1) mm and (47.1 ±15.1) for CT, while those were (40.3 ±3.1), (47.3 ±4.2) mm,(37.3 ±5.6), (45.3 ±3.3) mm,and (46.0 ± 14.8) for ultrasound, respectively. The CT results were correlated with the ultrasound ( n = 35, r = 0.886-0.988, P ＜ 0.01 ). (3) The average radiation exposure was ( 5.4 ± 0.5 ) mSv. Conclusions 320-row CT ECG-gated double phase cardiac function scan mode is feasible for the "one-stop-shop" examination of the cardiovascular disease. This noninvasive method is recommended for the diagnosis, differential diagnosis, treatment and prognosis of cardiovascular disease.