双源CT冠状动脉成像质量及影响因素分析

Study of image quality of dual source CT coronary angiography and influencing factors

目的本研究对150例疑诊冠心病患者双源CT冠脉图像进行回顾性分析,探讨图像质量的影响因素和改善措施。方法本研究包括接受双源CT冠脉检查的患者共150例,其中男98例,女52例,平均年龄58.3岁。冠脉图像评价共分为5级,Ⅰ级-Ⅲ级为合格诊断图像,Ⅳ、Ⅴ级为不合格图像。对于心率波动>10次/分患者采用小螺距扫描,造影剂注射速率4.5-5.5ml/s。结果150例患者均顺利完成检查,平均心率波动幅度9.3±7.1次/分(房颤1例除外)。150例中共计142例为合格图像,8例为不合格图像。8例图像中有5例(窦性心率不齐2例,室性早搏2例,心脏起搏二联律1例)经心电编辑后达到合格,其余3例(呼吸伪影2例,房颤1例)经后处理图像仍未达标。结论采用小螺距扫描可在一定程度降低心率不齐对双源CT冠脉图像的影响;熟练应用心电编辑及时相重建技术可有效提高图像的合格率。

Objective To investigate the influencing factors on image quality of dual source CT coronary angiography by retrospective analysis of the images of 150 patients with suspected coronary artery disease. Methods 150 cases of suspected coronary artery disease were included in this study（98 male, 52 female, mean age 58.3years）. Coronary artery images could be classified as 5 grade, grade 1 to 3 was defined as qualified images and grade 4 and 5 was defined as non-qualified images. Low ＂pitch＂± scanning technique was applied to patients with the fluctuation of heart rate more than 10 bpm. Results All of 150 cases undertook dual source CT coronary angiography smoothly, the average fluctuation of heart rate was 9.3 ± 7.1 bpm （1 case of atrial fibrillation was excluded）. Qualified images were obtained in 142 cases and the other 8 cases were non-qualified. By ECG-editing and multiple-phase reconstruction technique, 3 of 8 cases of non-qualified images reached optimal level. Conclusion Low ＂pitch＂± scanning technique could reduce the effect of irregular heart rate on image quality of dual source CT coronary angiography and application of ECG-editing and multiple-phase reconstruction technique skillfully would be an effective way to improve image quality.