64层螺旋CT时相检索与心电编辑在心律不齐患者冠状动脉成像中的应用

Optimization of 64-slice spiral CT coronary angiography by phase-searching and ECG-editing

目的探讨64层螺旋CT时相检索与心电编辑在心律不齐患者冠状动脉CT血管成像图像质量控制中的合理应用,评价两种处理方法的优越性与互补性。方法选取我院48例因各种因素致心律异常的拟诊冠心病患者行冠状动脉CTA检查,利用时相检索与心电编辑功能进行原始数据处理。结果28例因心率波动较大,在浏览原始图像、搜索最佳重建时间窗后,重建出满意的图像。余20例使用心电编辑功能剔除异位触发点,或手动编辑改变重建时间窗后,18例获得较满意的图像,仅1例图像质量较差,另1例失败。5分法图像质量分析显示,28例共计224个血管节段经时相检索重组后的冠状动脉图像中,能满足诊断要求者(3～5分为优良)达92.9%(208/224),图像质量勉强满足诊断要求者(2分为较差)占7.1%(16/224)。其余20例共计160个血管节段经心电编辑的冠状动脉图像中,能满足诊断要求者(3～5分为优良)达90.0%(144/160),勉强满足诊断要求者(2分为较差)占5.0%(8/160),仅1例失败,无法满足诊断要求。最后将两种方法处理后的图像质量进行综合评价,优良91.7%(352/384),较差6.2%(24/384),失败2.1%(8/384)。结论在冠状动脉CTA检查中对心律不齐的患者,合理选择时相检索与心电编辑功能进行原始数据重建是获得冠状动脉CTA高质量图像的有效手段。

Objective To optimize 64 - slice spiral CT coronary angiography by phase - searching and ECG - editing in patients with arrhythmia. Method Forty - eight patients suspected of coronary heart disease with fluctuant heart rate were examined by coronary CTA. The primary data were processed by phase - searching and ECG - editing, hnage reconstruction was successful in 28 patients with remarkable arrhythmia after searching best reconstruction window, and also in another 20 patients with unknown arrhythmia before and abnormal ECG signal in scanning after rejecting dystopia trigger points and editing reconstruction window by hand. Results The image quality analysis with 5 scores showed that 92.9% of reconstructed coronary image （26/28） could exactly meet the need of diagnosis （3 - 5 scores, good quality）, and 7.1% （2/28） barely did （2. scores, poor quality）. In 20 cases of ECG edited coronary image, 90.0% （18/20） had good quality, 5.0% （1/20） poor quality, and 5.0% （1/20） failed to meet the need of diagnosis. To sum up, the rates of good, poor, failed quality were 91.7% , 6.3% and 2.1% , respectively. Conclusions Optimization of 64 - slice spiral CT coronary angiography by phase - searching and ECG - editing for patients with arrbythmia is effective.