256层螺旋CT低剂量心脑血管联合成像初步研究
256층라선CT저제량심뇌혈관연합성상초보연구
Low dose 256-slice spiral CT of coronary combined with carotid and cerebrovascular angiography
  • 万方数据
    中华放射学杂志 중화방사학잡지
    Chinese Journal of Radiology
    2011年 11期 1008-1012 ,共5页

    张晓东%唐秉航%李芳云%李良才%黄晖%何亚奇%吴任国%黄德成%梁健雄%赖紫霞

    장효동%당병항%리방운%리량재%황휘%하아기%오임국%황덕성%량건웅%뢰자하

    体层摄影术,X线计算机%冠状血管%脑血管循环 體層攝影術,X線計算機%冠狀血管%腦血管循環
    체층섭영술,X선계산궤%관상혈관%뇌혈관순배
    Tomography,X-ray computed%Coronary vessels%Cerebrovascular circulation
    目的 初步探讨256层螺旋CT前瞻性心电门控心脑血管联合成像的图像质量与辐射剂量.方法 回顾性分析57例患者CTA资料.组1:心脑血管联合CTA(n=17),应用大范围前瞻性心电门控行冠状动脉、颈动脉及脑血管一站式扫描；组2:冠状动脉CTA(n=20):前瞻性心电门控行常规冠状动脉成像；组3:常规颈脑血管CTA(n =20).分别测量各组升主动脉根部、双侧颈总动脉起始部、椎动脉起始部、颈内动脉(蝶鞍层面)图像CT值与图像噪声；采用4分法评估冠状动脉图像质量,3分法评估颈脑血管图像质量；分别计算各组的辐射剂量.采用t检验比较组间的图像CT值与噪声；采用Mann-Whitney U检验比较组1与组2冠状动脉图像质量及组1与组3颈脑血管图像质量.结果 组1与组2升主动脉根部CT值[分别为(427±50)、(426±86) HU]、噪声[分别为(30±9)、(31±9)HU]差异均无统计学意义(t值分别为0.058、-0.325,P值均＞0.05)；冠状动脉图像质量评分组1与组2均满足诊断需要冠状动脉节段,优良分别达到98.1％( 202/206)、99.6％(244/245)；两组间图像质量比较差异无统计学意义(Z=- 0.572,P＞0.05).组1与组3颈总动脉起始部CT值[分别为(474±70)、(348±81)HU]、椎动脉起始部CT值[分别为(447±83)、(328±66) HU]差异均有统计学意义(t值分别为5.043、4.869,P值均＜0.05)；颈内动脉(蝶鞍层面)CT值[分别为(370±92)、(367±97)HU]两组比较差异无统计学意义(t=0.111,P＞0.05).组1颈脑血管图像质量评分1分1例,2分14例,3分2例；组3颈脑血管图像质量评分2分7例,3分13例；两组图像质量评分比较差异有统计学意义(Z=-3.306,P＜0.05).组1、组2、组3有效辐射剂量分别为(7.0±0.8)、(3.1±0.4)、(5.0±0.3) mSv.结论 256层螺旋CT大范围前瞻性心电门控心脑血管联合成像可获得满足临床诊断需要的冠状动脉、颈动脉及脑血管图像质量,具有简便、快捷、无创、对比剂使用少、辐射剂量低、客观和重复性强的优势,是一种全新的评估冠状动脉与颈脑血管的良好方法.
    목적 초보탐토256층라선CT전첨성심전문공심뇌혈관연합성상적도상질량여복사제량.방법 회고성분석57례환자CTA자료.조1:심뇌혈관연합CTA(n=17),응용대범위전첨성심전문공행관상동맥、경동맥급뇌혈관일참식소묘；조2:관상동맥CTA(n=20):전첨성심전문공행상규관상동맥성상；조3:상규경뇌혈관CTA(n =20).분별측량각조승주동맥근부、쌍측경총동맥기시부、추동맥기시부、경내동맥(접안층면)도상CT치여도상조성；채용4분법평고관상동맥도상질량,3분법평고경뇌혈관도상질량；분별계산각조적복사제량.채용t검험비교조간적도상CT치여조성；채용Mann-Whitney U검험비교조1여조2관상동맥도상질량급조1여조3경뇌혈관도상질량.결과 조1여조2승주동맥근부CT치[분별위(427±50)、(426±86) HU]、조성[분별위(30±9)、(31±9)HU]차이균무통계학의의(t치분별위0.058、-0.325,P치균＞0.05)；관상동맥도상질량평분조1여조2균만족진단수요관상동맥절단,우량분별체도98.1％( 202/206)、99.6％(244/245)；량조간도상질량비교차이무통계학의의(Z=- 0.572,P＞0.05).조1여조3경총동맥기시부CT치[분별위(474±70)、(348±81)HU]、추동맥기시부CT치[분별위(447±83)、(328±66) HU]차이균유통계학의의(t치분별위5.043、4.869,P치균＜0.05)；경내동맥(접안층면)CT치[분별위(370±92)、(367±97)HU]량조비교차이무통계학의의(t=0.111,P＞0.05).조1경뇌혈관도상질량평분1분1례,2분14례,3분2례；조3경뇌혈관도상질량평분2분7례,3분13례；량조도상질량평분비교차이유통계학의의(Z=-3.306,P＜0.05).조1、조2、조3유효복사제량분별위(7.0±0.8)、(3.1±0.4)、(5.0±0.3) mSv.결론 256층라선CT대범위전첨성심전문공심뇌혈관연합성상가획득만족림상진단수요적관상동맥、경동맥급뇌혈관도상질량,구유간편、쾌첩、무창、대비제사용소、복사제량저、객관화중복성강적우세,시일충전신적평고관상동맥여경뇌혈관적량호방법.
    Objective To investigate image quality and radiation dose of prospective ECG-gated coronary combined with carotid and cerebrovascular angiography and compare it with common coronary CTA and carotid-cerebrovascular CTA at a 256-slice spiral CT.Methods Fifty-seven patients were included in the study.The data was analyzed retrospectively and divided into 3 groups.Group 1 underwent coronary combined with carotid CTA ( n =17 ),which included a wide range of prospective ECG-gated coronary,carotid and cerebral vascular one-stop angiography.Group 2 underwent coronary CTA ( n =20),which was routine prospective ECG-gated coronary angiography.Group 3 underwent routine carotid and cerebrovascular CTA (n =20).Mean CT image attenuation and image noise were measured in the ascending aorta root,proximal parts of the bilateral common carotid artery and vertebral artery,and in the internal carotid artery at sellae level in the axial plane.Coronary artery image quality was rated using a four-point ordinal scale and carotid cerebral vascular image quality was rated using a three-point ordinal scale.Radiation dose were calculated.Mean CT image attenuation,image noise and radiation dose were compared among the 3 groups using t test.Using Mann-Whitney U,the coronary artery imaging quality was compared between group 1 and 2,and image quality of cerebral vessels was compared between group 1 and 3.Results Mean CT image attenuation [ (427 ±50) HU in group 1 and (426 ±86) HU in group 2] and image noise of the ascending aorta root [ (30 ± 9) HU in group 1 and (31 ± 9) HU in group 2 ] showed no statistical difference between group 1 and 2 (t =0.058,-0.325,P ＞0.05).There were no non-diagnosis coronary segments in group 1 and 2.And coronary segments with excellent or good image quality reached 98.1％ (202/206) in group 1 and 99.6％ ( 244/245 ) in group 2.It showed no significant difference between group 1 and 2 ( Z =-0.572,P ＞ 0.05 ).There were significant differences of mean CT image attenuation in the common carotid artery between group 1 [ ( 474 ± 70 ) HU ] and group 3 [ ( 348 ± 81 ) HU ],and in the vertebral artery between group 1 [(447 ±83)HU] and group 3 [(328 +66) HU] (t =5.043,4.869,P＜0.05).However,there was no significant difference of mean CT image attenuation in the internal carotid artery [ (370 ± 92) HU in group 1 and ( 367 ± 97 ) HU in group 3 ] ( t =0.111,P ＞ 0.05 ).There was a significant difference of image quality scores of carotid and cerebrovascular arteries between group 1 and 3 (Z =- 3.306,P ＜ 0.05 ).Effective radiation dose of groups 1,2,3 were ( 7.0 ± 0.8 ),( 3.1 ± 0.4 ) and (5.0 ± 0.3) mSv respectively.Conclusion The prospective ECG-gated coronary combined with carotid and cerebrovascular angiography is able to obtain diagnostic image quality of coronary,carotid and cerebral vascular at the 256-slice spiral CT.It is a simple,fast,noninvasive way to assess coronary and carotid cerebrovascular arteries,with advantages of less contrast medium and low radiation dose.
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