| 孟 捷,李念云,解学乾,王 悍,王庆国.自由呼吸状态下冠状动脉CT血管成像的可行性研究[J].,2018,(19):3661-3664 |
| 自由呼吸状态下冠状动脉CT血管成像的可行性研究 |
| Feasibility of Free-breathing Coronary CT Angiography |
| 投稿时间：2018-05-27 修订日期：2018-06-21 |
| DOI：10.13241/j.cnki.pmb.2018.19.013 |
| 中文关键词: 体层摄影术 X线计算机 血管成像 冠状动脉 自由呼吸 图像质量 前瞻性心电门控 |
| 英文关键词: Tomography, X-ray computed Angiography Coronary artery Free breathing Image quality Prospective gated |
| 基金项目:上海市浦江人才计划资助基金项目(17PJ1408000) |
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| 中文摘要: |
| 摘要 目的：探讨自由呼吸状态下冠状动脉CT血管成像(Coronary CT Angiography, CCTA)的可行性。方法：收集187例疑似冠心病患者，所有患者均行CCTA检查，其中108例采用传统屏气法扫描，79例采用自由呼吸法扫描。扫描采用前门控预估法（Auto Gating）测得冠脉扫描期相，设置扫描范围和参数（准直宽度256×0.625、224×0.625、192×0.625，球管转速0.28 s，kV100，智能管电流，噪声指数25）。对比剂浓度为370 mgI/mL，注药量为0.86 mL/kg，注药时间维持12 s。由2名高年资放射科医师对冠状动脉图像采用5分法评分。测量升主动脉根部（冠状动脉左主干开口水平）和胸壁肌肉的CT值及标准差，计算图像的信噪比和对比噪声比。结果：自由呼吸状态下右冠状动脉（Right coronary artery, RCA）、左前降支（Left ascending artery, LAD）、左旋支（Left circumflex artery, LCx）的优良血管率分别为46.5%（87/187）、51.9%（97/187）及48.7%（91/187）；屏气状态下RCA、LAD、LCx的优良血管率分别为32.6%（61/187）、36.4%（68/187）及36.9%（69/187），两组之间无统计学差异（Fisher值分别为6.94、1.54、0.81，P均＞0.05）。采用自由呼吸和屏气状态下CCTA检查的主动脉CT值、噪声、SNR和CNR均无统计学差异（P均＞0.05）。结论：采用超宽探测器CT，自由呼吸法CCTA可完全取代传统屏气法CCTA检查，从而降低受检者的配合难度，提高工作效率。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the feasibility of free-breathing coronary CT angiography (CCTA). Methods: Coronary CT angiography was performed in 187 patients with suspected coronary heart disease. Of all cases, 108 were scanned under traditional breath holding and 79 were scanned under free breathing. The scanning phase estimation technique (Auto Gating) was used to determine the op- - timum phase of coronary scan, and the scanning range and sequence parameters were arranged (collimation width: 256×0.625 mm, 224×0.625 mm, 192×0.625 mm, rotation rate: 0.28 s, kV100, intelligence tube current, noise index: 25). The concentration of contrast medium was 370 mgI/mL, the injection dose was 0.86 mL/kg, and the injection maintenance time was 12s. Image quality of coronary artery was scored by two experienced radiologist using five point scales. The CT value and standard deviation of aortic root and chest wall muscle were measured, and noise-signal ratio and contrast-noise ratio were calculated. Results: Under the condition of free respira- tion, the excellent and good image quality (score 4 and 5) ratio of RCA, LAD and LCx were 46.5% (87/187), 51.9% (97/187) and 48.7% (91/187), respectively. Under the condition of breath holding, the excellent and good image quality ratio of RCA and LAD, excellent rate of LCx was 32.6% (61/187), 36.4% (68/187) and 36.9% (69/187). There was no significant difference between the two groups (Fisher= 6.94, 1.54, 0.81, all P values > 0.05). The CT value, noise, SNR and CNR of the aorta were not statistically different(P>0.05) between the two groups. Conclusion: When using the ultra wide detector CT, the free breathing CCTA can replace the traditional breath holding CC- TA, thus reducing the cooperation difficulty of patient and improving the work efficiency. |
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