CAJ | 학술논문

目的：探讨在双源 CT 冠状动脉成像中,前瞻和适应性前瞻门控序列分别对低心率(≤65次/min)、高心率(65次/min<心率≤90次/min)患者的临床应用价值。方法将255例行冠状动脉 CTA 检查的患者(心率≤90次/min)随机分为 A、B 2组,分别采用前瞻性、回顾性门控扫描,其中,A、B 组又进一步分为低心率组和高心率组,分别记为 A1、A2、B1、B2组,A1、A2组分别接受前瞻和适应性前瞻扫描；B1、B2组均采用回顾性门控扫描,各组实际收集病例数分别为：A1组51例、A2组89例、B1组26例和 B2组89例；记录各组有效辐射剂量,由2位高年资心血管诊断医师,采用4分法对各组图像质量进行评价。结果 A、B 组中图像质量评分为1~2分的均占95%以上,A1与 B1、A2与 B2组间图像质量差异均无统计学意义(P =0.726、P =0.079),而有效辐射剂量差异有统计学意义(P <0.001),前者较后者分别降低了50%、40%。结论在双源 CT 冠状动脉成像中,应用前瞻及适应性前瞻门控序列,对心率≤90次/min 患者均可获得较满意的、满足临床诊断图像,同时可大大降低辐射剂量。
목적：탐토재쌍원 CT 관상동맥성상중,전첨화괄응성전첨문공서렬분별대저심솔(≤65차/min)、고심솔(65차/min<심솔≤90차/min)환자적림상응용개치。방법장255례행관상동맥 CTA 검사적환자(심솔≤90차/min)수궤분위 A、B 2조,분별채용전첨성、회고성문공소묘,기중,A、B 조우진일보분위저심솔조화고심솔조,분별기위 A1、A2、B1、B2조,A1、A2조분별접수전첨화괄응성전첨소묘；B1、B2조균채용회고성문공소묘,각조실제수집병례수분별위：A1조51례、A2조89례、B1조26례화 B2조89례；기록각조유효복사제량,유2위고년자심혈관진단의사,채용4분법대각조도상질량진행평개。결과 A、B 조중도상질량평분위1~2분적균점95%이상,A1여 B1、A2여 B2조간도상질량차이균무통계학의의(P =0.726、P =0.079),이유효복사제량차이유통계학의의(P <0.001),전자교후자분별강저료50%、40%。결론재쌍원 CT 관상동맥성상중,응용전첨급괄응성전첨문공서렬,대심솔≤90차/min 환자균가획득교만의적、만족림상진단도상,동시가대대강저복사제량。
Objective To investigate the feasibility and clinical application of prospective ECG-gated scan and adaptive cardio se-quence scan of dual-source CT coronary angiography.Methods 255 patients who underwent coronary CT angiography using a dual-source CT scanner were divided into two groups:group A underwent prospective scan,group B underwent retrospective scan.The two groups were further subdivided into low heart rate group and high heart rate group,recorded as A1(n=51),A2(n=89),B1(n=26), B2(n=89),respectively.Group A1 preceded with prospective ECG gated scan;group A2 performed with adaptive cardio sequence scan;group B1 and B2 underwent retrospective scan.All of them applied ATCM (automatic tube current modulation)technique. Effective dose was recorded.The image quality was assessed by two experienced radiologists with a four-point grading scale.Results The excellent or good image quality (score 1 and 2)of the four groups were above 95%,and no statistical differences in images scores was detected in A1 and B1 (P =0.726),A2 and B2 (P =0.079).Effective dose was significantly different in A1 and B1(P <0.001),A2 and B2 (P <0.001),and the former decreased 50% and 40% as compared with the latter.Conclusion Using prospective ECG gated scan and adaptive cardio sequence scan,assessable image quality of coronary artery can be acquired with dual source CT (heart rate<90 beast per minute),and radiation dose can be obviously reduced.