窄窗扫描技术在高心率患者320排CT冠状动脉成像中的应用研究.pdfVIP

心电与循环2014 年第33 卷第4 期 论 著 窄窗扫描技术在高心率患者320 排CT 冠状动脉成像中的应用研究 舒震宇 丁忠祥 王振 徐健 林毅 [摘要] 目 探讨高心律患者320 排CT 冠状动脉成像使用前瞻性心电门控窄窗扫描技术对图像质量和辐射剂量的影 响。 方法 80 例心率在80~100 次/ min 的患者随机分成观察组和对照组。观察组按R-R 间期30 ％～50 ％进行前瞻性窄 窗扫描3 个心动周期，对照组按 R-R 间期30 ％～80％进行常规扫描3 个心动周期，冠状动脉节段图像质量采用4 级评分法 评分,辐射剂量值由设备自动计算。 结果 可评价血管段和优良率两组间差异无统计 意义（P ＞0.05 ）。冠状动脉总节段、 冠状动脉（RCA ）、左冠状动脉主干（LM ）、左前降支（LAD ）和旋支（LCX ）的质量评分两组间差异无统计 意义（P ＞0.05 ）。观 察组的RCA 和LCX 与心律波动呈中等程度负相关 （r =0.41 、0.47 ）。观察组和对照组平均辐射剂量分别为（7.63 ±3.29 ）和 （12.85 ±2.71 ）mSv ，差异有统计学意义（t=1.384 ，P 0.05 ）。 结论 窄窗扫描技术可应用在心律波动不大的高心率患者， 能明显降低辐射剂量而不影响图像质量。 [关键词] 640 层CT ； 高心率； 窄窗技术； 冠状动脉成像； 辐射剂量 Application of Narrow window scan in coronary 320-MDCT angiography of patients with high heart rate SH U Zhenyu, DING Zhongxiang, WA NG Zhen, et al. Dep artment of Radiology, Zhej iang Prov inc ial Peop le s Hosp ital, H angz hou 310014, China Corresp onding author: SH U Zhenyu, E-mail ：9798714 @ [Abstract] Objective To investigate the influence of prospective narrow window scan on the image quality and radiation dose of coronary 320-MDCT angiography in patients with high heart rate. Methods 80 patients with heart rate between 80 and 100 bpm were randomly divided into observation group and control group. Prospective scanning with an ECG-gated window of 30-50% of the R-R interval was performed in observation group and 30-80% of the R-R interval gated routine scan was acquired in control group in three heartbeats. Coronary artery image was scored using 4-point scale. The radiation dose was automatically calculated by the CT scanner. Results There was no significant difference of assessable coronary segments and excellent rate between two groups. The image quality scores of total coronary segments, RCA, LM, LAD and LCX were not significant difference between two groups. The image quality score of