256层螺旋CT心电门控成像在诊断先天性心脏病中的临床应用

Clinical application of ECG-gated 256-slice CT angiography for diagnosis of congenital heart disease

目的:探讨256层螺旋CT心电门控成像在诊断先天性心脏病中的临床应用,阐明前瞻性心电门控成像与回顾性心电门控成像的图像质量与射线剂量的关系。方法:对60例怀疑先天性心脏病的患者进行心脏CT造影成像,将60例患者分为2组:前瞻性心电门控成像组和回顾性心电门控成像组,每组30例。然后对2组图像的血管强化程度、阶梯伪影、图像整体评价和有效剂量进行评估。结果:前瞻性心电门控成像组及回顾性心电门控成像组图像血管强化程度评分分别为2.8±0.3和2.7±0.6,差异无统计学意义(P>0.05);图像阶梯伪影评分分别为3.0±0.9和3.1±0.9,差异无统计学意义(P>0.05);图像整体评分分别为3.0±0.8和3.1±0.9,差异无统计学意义(P>0.05);前瞻性心电门控成像组及回顾性心电门控成像组的有效剂量分别为(5.24±0.52)mSv和(16.68±1.49)mSv,差异有统计学意义(P<0.001)。结论:同回顾性心电门控成像比较,前瞻性心电门控成像心脏CT造影在图像质量满足诊断的情况下,射线剂量降低约68.6%,具有较好的临床应用前景。

Objective To investigate the clinical application of ECG-gated 256-slice CT angiography for diagnosis of congenital heart disease,and to evaluate the relationship of the image quality and radiation dose between prospective ECG-gated and retrospective ECG-gated cardiac CT angiography（CTA）.Methods Sixty patients who doubt congenital heart disease underwent cardiac CTA,and they were randomly divided into two groups.Thirty patients in group A underwent prospective ECG-gated cardiac CTA,and thirty patients in group B underwent retrospective ECG-gated cardiac CTA.Then the homogeneous enhancement of vascular structures,stair-step artifact,overall image quality and radiation dose were evaluated.Results The homogeneous enhancement of vascular structures were 2.8±0.3 and 2.7±0.6,respectively,in two groups;and there was no statistical significance（P0.05）.The stair-step artifact were 3.0±0.9 and 3.1±0.9,respectively,in two groups;and there was also no statistical significance（P0.05）.The overall image quality were 3.0±0.8 and 3.1±0.9,respectively,in two groups;and there was statistical significance（P0.05）.However,the effective dose were（5.24±0.52） mSv and（16.68±1.49） mSv,respectively,in two groups;and there was statistical significance（P0.001）.Conclusion Compared with retrospective ECG-gated cardiac CTA,prospective ECG-gated cardiac CTA can reduce radiation dose about 68.6%,while maintaining the image quality which could be made diagnosis.