心律对64层螺旋CT冠状动脉造影的影响及心电编辑软件对心律不齐图像的质量控制

The influence of cardiac rhythm on image quality of 64-slice spiral CT in coronary angiography and the value of ECG editing in arrhythmias

目的:评价心律对64层螺旋CT冠状动脉图像质量的影响,分析心电编辑软件对心律不齐图像的质量控制。方法:把112例患者按心率波动幅度分成4组:A组0～4次/min、B组5～9次/min、C组10～14次/min和D组≥15次/min。在心电门控下进行64层螺旋CT冠状动脉容积扫描,采用回顾性心电门控技术进行图像重建,对各组重建图像进行定量评分,比较组间差异;对其中因心律不齐而图像质量欠佳的26例患者进行了心电编辑,分析编辑前后图像质量差异。结果:除RCA2外,A、B、C组间无统计学差异,而A、B、C组与D组有统计学差异;RCA2受心律影响明显,其与心率波动幅度呈负相关(P<0.001,r=-0.488);心电编辑前后图像质量有统计学差异(P<0.001),编辑后图像质量提高。结论:心律是64层螺旋CT成像重要影响因素之一,当心率波动≥15次/min时64层螺旋CT冠状动脉成像受影响重;心电编辑软件对心律不齐冠脉图像质量有提升作用。

Objective：To analyze the influence of cardiac rhythm on image quality in coronary angiography with 64-slice spiral CT and to investigate the value of ECG editing in improving the image quality of arrhythmias.Methods：A retrospective study was undertaken in 112 cases which had 64-spiral CT scan in coronary angiography.The 112 cases were divided into 4 groups according to the heart rate fluctuation.Group A 0～4 bpm,Group B 5～9 bpm,Group C 10～14 bpm,and Group D≥15 bpm.The image qualities of brands or segments of coronary arteries（total 1 118）were compared between different groups;26 patients with previously known arrhythmia or arrhythmia merely occurring during the examination,their coronary angiographies were obtained respectively using original synchronously record ECG or using the ECG after being edited with the ECG editing software.The image quality was compared before and after the editing.Results：There was no significant difference between group A、B and C except RCA2,but the difference between group D and A、B、C was obvious（P〈0.001）.The influence of cardiac rhythm to R CA2 was heavy（P〈0.001,r=-0.488）;There was significant statistical difference between before and after editing（P〈0.001）.Conclusion：The cardiac rhythm is one important factor in image quality of 64-slice spiral CT in coronary angiography.The ECG editing can be used to improve the image quality of coronary angiography in arrhythmias.