256层CT前瞻与回顾性心电门控冠状动脉成像的应用研究

The Application Research of Prospective and Retrospective Eectrocardiogram Gated 256-slice Computed Tomography Coronary Angiography

目的通过256层CT前瞻性心电门控与回顾性心电门控冠状动脉成像的辐射剂量和成像质量等比较,探讨前瞻性心电门控CT冠状动脉成像的可行性。资料与方法拟诊冠状动脉粥样硬化性心脏病(CHD)两组患者分别进行前瞻性和回顾性心电门控扫描,并采用最大密度投影(MIP)、容积再现(VR)、多平面重组(MPR)及曲面重组(CPR)多种重组技术显示各节段冠状动脉,图像质量根据对诊断影响分为优、良、差,并计算各自有效辐射剂量,进行统计学分析。结果前瞻性组平均辐射剂量为(2.11±0.48)mSv,明显低于回顾性组的(9.15±1.59)mSv(P<0.01);前瞻性组冠状动脉节段图像质量优良及差者分别占96.7%(1259/1302)和3.3%(43/1302),与回顾性组的96.3%(1339/1390)和3.7%(51/1390)比较,差异无统计学意义。结论 256层CT前瞻性心电门控冠状动脉成像能以较低的辐射剂量取得优质图像,更适合CHD患者的早期筛查。

Objective To compare the prospective electrocardiogram（ECG） triggered computed tomography coronary angiography（CTCA） with retrospective ECG-gated CTCA.Materials and Methods Patients with suspected coronary artery disease（CHD） were divided into two groups,in which the patients underwent CTCA with prospective ECG-triggered or retrospective ECG-gated scanning（n=220 each）.Maximum intensity projection（MIP）,volume rendering（VR）,Multi-planar reconstruction（MPR）,and curved planar reconstruction（CPR）were used to diagnosis the coronary arteries.Individual radiation exposure dose was estimated from the dose-length.Results The mean effective radiation dose of prospective（2.11±0.48 mSv） was significantly lower than that of retrospective ECG-gated（9.15±1.59 mSv）.Segments of image quality（96.7% and 3.3%） in prospective ECG triggered group were similar as those of retrospective ECG gated group（96.3% and 3.7%）.Conclusion The perfect images can be obtained with prospective ECG triggered CTCA with lower radiation dose,which is an optimal method for early screening.