CAJ | 학술논문

目的评估第二代双源CT(dual-source CT,DSCT)前瞻性ECG管电流调制技术右心室功能分析的准确性及辐射剂量.方法连续48例临床怀疑或确诊为冠心病患者行冠状动脉CT成像和MRI心功能检查.冠状动脉成像使用DSCT序列扫描模式联合前瞻性ECG管电流调制技术,总扫描窗宽设为30％～ 90％ R-R间期,依据心率在70％(心率≤70次/min时)或40％(心率＞70次/min时)R-R间期全电流输出,其余间期使用全电流的20％输出.以美国心脏病协会冠状动脉分法为基础,将冠状动脉分为16段,用4分法对各段冠状动脉图像质量进行评价.以5％的R-R间隔重建扫描数据进行右心室功能分析,记录右心室收缩末期容积(RVESV)、舒张末期容积(RVEDV)及射血分数(RVEF)值,并以MRI所测得的相应数据为对照进行统计学分析.结果 42例患者顺利完成了DSCT冠状动脉成像、右心室功能分析和MRI右心室功能分析.共评价冠状动脉558段,其中可用于诊断的节段占96.42％,平均辐射剂量为(2.82±0.55) mSv.DSCT与MRI所测的RVESV、RVEDV和RVEF值差异无统计学意义(P＞0.05),且两种检查的RVESV、RVEDV和RVEF值有很高的相关性(r=0.89、0.89、0.87,P＞0.05).结论第二代DSCT前瞻性ECG管电流调制技术可以用于兼顾冠状动脉成像及右心室功能分析的“一站式”检查,冠状动脉可诊断率高,右心室功能分析结果可靠,平均辐射剂量较低.
목적 평고제이대쌍원CT(dual-source CT,DSCT)전첨성ECG관전류조제기술우심실공능분석적준학성급복사제량.방법 련속48례림상부의혹학진위관심병환자행관상동맥CT성상화MRI심공능검사.관상동맥성상사용DSCT서렬소묘모식연합전첨성ECG관전류조제기술,총소묘창관설위30％～ 90％ R-R간기,의거심솔재70％(심솔≤70차/min시)혹40％(심솔＞70차/min시)R-R간기전전류수출,기여간기사용전전류적20％수출.이미국심장병협회관상동맥분법위기출,장관상동맥분위16단,용4분법대각단관상동맥도상질량진행평개.이5％적R-R간격중건소묘수거진행우심실공능분석,기록우심실수축말기용적(RVESV)、서장말기용적(RVEDV)급사혈분수(RVEF)치,병이MRI소측득적상응수거위대조진행통계학분석.결과 42례환자순리완성료DSCT관상동맥성상、우심실공능분석화MRI우심실공능분석.공평개관상동맥558단,기중가용우진단적절단점96.42％,평균복사제량위(2.82±0.55) mSv.DSCT여MRI소측적RVESV、RVEDV화RVEF치차이무통계학의의(P＞0.05),차량충검사적RVESV、RVEDV화RVEF치유흔고적상관성(r=0.89、0.89、0.87,P＞0.05).결론 제이대DSCT전첨성ECG관전류조제기술가이용우겸고관상동맥성상급우심실공능분석적“일참식”검사,관상동맥가진단솔고,우심실공능분석결과가고,평균복사제량교저.
Objective To explore the accuracy and radiation dose of the right ventricular analysis with DSCT(dual-source computed tomography)using dual-step prospective ECG trigger.Methods Fortyeight consecutive patients who were suspected or diagnosed with coronary artery disease were examined with DSCT coronary angiography and MRI ventricular analysis.Sequential acquisition and dual-step prospective ECG-trigger were used with 30％-90％ width R-R interval.Full tube current output was adopted at 70％ (HR ≤70 bpm)or 40％ (HR ＞ 70 bpm) R-R interval according to heart rates,while 20％ current output was adopted in other R-R interval.Coronary artery was divided into 16 segments according to the American Heart Association.Image quality of coronary arteries were graded with 4-points scale.The DSCT date was reconstructed with 5％ R-R interval.RVESV,RVEDV and RVEF were evaluated in DSCT and MRI.Results Forty-two cases accomplished DSCT and MRI examination.In 558 evaluated coronary segments,96.42％ could be diagnosed.The average radiation dose was(2.82 ± 0.55)mSy.Paired t-test indicated that the RVESV,RVEDV and RVEF of DSCT and MRI had no statistically significant differences (t =-0.28,0.44 and 1.49,P＞0.05),and the correlation was high (r =0.89,0.89,0.87).Conclusions The two generation DSCT with dual-step prospective ECG-triggered sequential acquisition can be used in coronary angiography and right ventricular function analysis simultaneously,which is high in imaging quality of coronary artery,reliable in right ventricular function analysis,as well as lower in radiation dose.