CAJ | 학술논문

目的：探讨心电编辑技术在64层螺旋C T冠状动脉成像检查中心电信号异常患者中的应用价值。方法病例选取我院行64层螺旋C T经静脉冠状动脉造影，且心率不齐，常规重组伪影严重，影响影像诊断的患者共36例。对常规CT重组影像和心电编辑后重组影像质量进行比较，根据节段显示情况及是否存在伪影将图像质量分为I～Ⅳ级，I～Ⅲ级符合影像学评价要求，I～Ⅱ级为优良阶段。比较64层螺旋C T回顾性心电门控结合心电编辑技术对心电获得异常患者的冠状动脉影像质量的影响。结果36例患者心电编辑前后可显示冠脉总数分别为521段和528段，心电编辑前图像质量Ⅰ、Ⅱ、Ⅲ、Ⅳ级节段分别为133段（25．5％）、162段（31．1％）、120段（23．0％）、106段（20．3％），图像质量符合诊断要求的共415段（79．6％）。心电编辑后图像质量Ⅰ、Ⅱ、Ⅲ、Ⅳ级节段分别为439段（83．1％）、70段（13．3％）、8段（1．5％）、11段（2．1％），冠状动脉显影优良节段为509段（96．4％），符合诊断要求节段共517段（97．9％），冠状动脉各段在心电编辑前后的影像质量差异均有统计学意义（ P ＜0．05）。结论心电信号编辑能明显改善部分期前收缩和心电信号中出现触发点异常患者的冠状动脉MSCTA图像质量，具有一定的临床实用价值。
목적：탐토심전편집기술재64층라선C T관상동맥성상검사중심전신호이상환자중적응용개치。방법병례선취아원행64층라선C T경정맥관상동맥조영，차심솔불제，상규중조위영엄중，영향영상진단적환자공36례。대상규CT중조영상화심전편집후중조영상질량진행비교，근거절단현시정황급시부존재위영장도상질량분위I～Ⅳ급，I～Ⅲ급부합영상학평개요구，I～Ⅱ급위우량계단。비교64층라선C T회고성심전문공결합심전편집기술대심전획득이상환자적관상동맥영상질량적영향。결과36례환자심전편집전후가현시관맥총수분별위521단화528단，심전편집전도상질량Ⅰ、Ⅱ、Ⅲ、Ⅳ급절단분별위133단（25．5％）、162단（31．1％）、120단（23．0％）、106단（20．3％），도상질량부합진단요구적공415단（79．6％）。심전편집후도상질량Ⅰ、Ⅱ、Ⅲ、Ⅳ급절단분별위439단（83．1％）、70단（13．3％）、8단（1．5％）、11단（2．1％），관상동맥현영우량절단위509단（96．4％），부합진단요구절단공517단（97．9％），관상동맥각단재심전편집전후적영상질량차이균유통계학의의（ P ＜0．05）。결론심전신호편집능명현개선부분기전수축화심전신호중출현촉발점이상환자적관상동맥MSCTA도상질량，구유일정적림상실용개치。
Objective To prospectively evaluate to what extent image quality in 64‐detector row computed tomographic (CT ) coronary angiography is a function of electrocardiographic editing and the image reconstruction technique used . Methods A total of 36 patients (14 men ,22 women ;mean age ,61 .0 years ± 9 .1) in department of radiology consecutive‐ly underwent multi‐detector row CT coronary angiography .Their electrocardiographic trigger points were proved to be in‐accurately or absent ,which caused unequal R‐R intervals .Image reconstruction was based on both before and after electro‐cardiographic trigger points editing .Reconstructed images were classified by artifacts as grades I ~ Ⅳ ,in which grades I~Ⅲ were considered to have diagnostic value .Results Among the total of 36 patients ,there were 521 and 528 segments of coronary arteries before and after electrocardiographic editing ,respectively .Before electrocardiographic editing ,images quality of grades Ⅰ ,Ⅱ ,Ⅲ ,Ⅳ were 133 (25 .5% ) ,162 (31 .1% ) ,120 (23 .0% ) ,106 (20 .3% ) ,respectively .It was 415 (79 .6% ) segments that with diagnostic value .After electrocardiographic editing ,images quality of grades Ⅰ ,Ⅱ ,Ⅲ ,Ⅳ were 439 (83 .1% ) ,70 (13 .3% ) ,8(1 .5% ) ,11(2 .1% ) ,respectively .It was 517 (97 .9% ) segments that with diagnostic value .There was significant difference between before and after electrocardiographic trigger points editing ( P<0.05) .Conclusion In multi‐detector row CT coronary angiography ,when inaccurately or absent electrocardiographic trigger points were found ,image quality could be improved by retrospective electrocardiographic gating technique combined with electrocardiographic editing techniques .