2019 年第 3 期 第 14 卷

两种不同扫描方式对CT冠状动脉成像检查中图像质量和辐射剂量的影响

Effects of two scanning methods on image quality and radiation dose in CT coronary angiography

作者：李红梅华莉张才慧张珊张记清张月英

英文作者：

单位：030000太原，山西医科大学第二医院影像科(李红梅、张才慧、张月英)；030000太原，山西医科大学护理学院(华莉、张珊、张记清)

英文单位：

关键词：冠状动脉疾病；计算机体层血管成像；图像质量；辐射剂量

英文关键词：

• 摘要：

• 【摘要】目的    探讨前瞻性心电门控扫描与回顾性心电门控扫描在CT冠状动脉成像（CTCA）中对图像质量和辐射剂量的影响。方法    以2016年3—12月在山西医科大学第二医院行CTCA检查的180例患者为研究对象，按照检查的单双日随机分为A组（92例）和B组（88例）。A组接受前瞻性心电门控冠状动脉检查，B组接受回顾性心电门控冠状动脉检查。收集患者的影像学资料，对其图像质量及辐射剂量进行评价。结果    2组患者性别、年龄、体重指数、扫描前心率差异均无统计学意义（均P>0.05）。B组扫描时心率、心率变异数高于A组，差异均有统计学意义（P<0.01）。以图像质量评分≥3分为判断标准，B组与A组患者可用于诊断的冠状动脉节段比例差异无统计学意义（χ2=1.37，P>0.05）。以图像质量评分≥2分为判断标准，B组可用于诊断的冠状动脉节段比例低于A组［93.4%（674/722）比97.4%（835/857）］，差异有统计学意义（χ2=15.42,P<0.05）。B组有效辐射剂量高于A组［（6.9±0.6）mSv比（2.3±0.6）mSv］，差异有统计学意义（P<0.01）。结论    CTCA检查中，将心率控制在一个适当范围内（<70次/min），前瞻性心电门控扫描可以在获得优质图像的同时明显降低辐射剂量。

• 【Abstract】Objective    To investigate the effects of prospective electrocardiographic(ECG) gated scanning and retrospective ECG gated scanning on image quality and radiation dose in CT coronary angiography(CTCA). Methods    A total of 180 patients undergoing CTCA examination from March to December 2016 in Second Hospital of Shanxi Medical University were randomly divided into group A(92 cases) and group B(88 cases). Group A had prospective ECG gated cardiac scanning and group B had retrospective ECG gated scanning. Image quality and radiation dose were evaluated. Results    Gender, age, body mass index and pre-scanning heart rate were similar between groups(all P>0.05). Heart rate and heart rate variability during scanning in group B were significantly higher than those in group A(P<0.01). With image quality score≥3 used as the judging standard, there was no significant difference of the percentage of coronary artery segments available for diagnosis between groups(χ2=1.37， P>0.05). Using image quality score≥2 as the standard, group B showed higher quality of images that could be used for specific diagnosis than group A［93.4%（674/722） vs 97.4%（835/857）］（χ2=15.42, P<0.05）. Effective radiation dose in group B was significantly higher than that in group A［（6.9±0.6）mSv vs （2.3±0.6）mSv］（P<0.01）. Conclusion    With an appropriate range of heart rate(<70 beats/min), using prospective ECG gated scanning of CTCA can obtain high-quality image and reduce radiation dose.