自然心率下成人256层螺旋CT冠状动脉成像的应用

目的:探讨自然心率下成人256层螺旋CT冠状动脉成像的图像质量及临床应用。方法:对112名患者行256层螺旋CT冠脉成像,根据心率将其分成两组,第1组心率≤75次/分54例,第2组心率>75次/分58例。两组患者在扫描前均未服用降心率药,通过解释、适当休息、吸氧等措施疏导患者的紧张情绪,采用回顾性心电门控模式采集,进行最大密度投影(MIP)、曲面重建(CPR)、容积再现(VR)技术重组,将图像质量分级,按美国AHA分段标准对冠状动脉各个节段的图像质量进行评价。结果:全部患者均成功获得冠状动脉影像,第1组的冠状动脉节段图像优良者占96.4%,差者占3.6%,第2组图像优良者占95.1%,差者占4.9%,两者比较差异无统计学意义。结论:在无心率控制下,256层螺旋CT成人冠状动脉成像可取得优质图像,更适合在临床冠心病患者的筛查中使用。

Objective：To discuss image quality and clinical application of 256-slice CT on adult coronary angiography without the control of heart rate.Method：112 patients received coronary CTA by the 256-slice CT scanner in this institute,divided into two groups according to heart rate,heart rate≤75beats/min（group 1,n=54）,heart rate 75 beats/min（group 2,n=58）,neither group of patients were taken drug before scan,we made the patients calm down by explanation,rest,oxygen inspiration.Coronary CTA was performed using retrospective ECG-gated,and post-processing MIP,CPR,VR,grading images by their quality,analyze imaging quality according to American AHA guidelines.Results：All patients underwent CT examinations successfully.Diagnostic image quality was achieved in 96.4% of the coronary artery segments of group 1 and 95.1% in group 2（p0.05）.Conclusion：Without heart rate control,256-slice CT on adult coronary angiography is enough to image the cardiac anatomy,which makes coronary CTA examination more convenient.