新双源CT冠脉成像的不同心电采集模式的人体X线吸收剂量及应用价值

X-ray absorption dosage of new dual-source CT coronary imaging of three kinds of ecg acquisition model and its application value

目的:研究新双源CT冠脉成像的3种不同心电采集模式的人体X线吸收剂量及价值。方法:2012年3月～2012年6月CT冠脉成像的患者共362例,根据心率分为三组,A组161例为节律规整,心率≤75次/min,B组126例为节律规整,心率>75次/min的患者,C组75例为心律不齐,早搏≥5次/min,心率>75次/min的患者,三组患者根据心率分别采取三种扫描模式(Flash Cardio SAFIRE)扫描模式即高螺距低剂量螺旋扫描模式;DS_CoronaryCTA_AdaptSeq扫描模式即前瞻性ECG触发三维序列扫描模式;DS_CoronaryCTA_SAFIRE扫描模式即回顾性ECG门控并通过SAFIRE减少剂量的螺旋扫描模式)进行扫描,所有患者检查前均未使用心率控制药物,观察三组患者X线吸收剂量:结果:41例因呼吸运动图像出现错列,确定为成像失败,其中A组失败7例(7/161),B组失败22例(22/126),C组失败14例(14/75);失败率为11.33%,符合诊断要求的321例(321/362),占88.67%。比较三种不同心电采集模式的人体X线吸收剂量,A组DLP为(53±19)mGry.cm,ED为(0.601±0.361)mSv,B组DLP为(241±81)mGry.cm,ED为(1.252±0.802)mSv;X线吸收剂量大大低于C组。组间比较差异具有显著性,有统计学意义P<0.05。结论:Flash_Cardio_SAFIRE扫描模式和DS_Coronar-yCTA_AdaptSeq扫描模式的X线吸收剂量大大低于DS_CoronaryCTA_SAFIRE扫描模式,并且可同样获得有价值的冠脉成像。

Objective： To explore the X-ray absorption dosage of new dual-source CT coronary imaging of three kinds of ecg acquisition model and its application value. Methods： A total of 362 patients that underwent coronary CT imaging during March 2012-June 2012 were enrolled and divided into 3 groups, of which group A were patients with regular rhythm, heart beat rates were less than 75 / min （n=161 cases）, group B were patients with regular rhythm, heart beat rates were more than 75 / rain （n= 126 cases）, group C were patients with irregular rhythm, heart beat rates were more than 75 / min （n= 126 cases）, premature heart beat rates were more than 5 / min （n= 126 cases）. The three groups underwent Flash_Cardio_SAFIRE mode; DS_CoronaryCTA_AdaptSeq mode; DS_CoronaryCTA_SAFIRE mode of CT coronary imaging, respectively. All patients were given drugs to control heart beats, and X-ray absorption dosage were observed and compared. Results： Imaging failure occurred in 41 cases due to breathing, of which 7 patients were from group A （7/161）, 22 from group B （22/126）, and 14 cases from group C （14/75）. Failure rate was 11.33%. For 321 cases, image quality met the requirements for diagnosis （321/362, 88.67%）. Human body X-ray absorption dosage was DLP （53 ± 19） mGry. cm and ED （0. 601 ＋ /--0. 361） mSv for group A; DLP （241 -b 81） mGry. Cm, ED （1. 252＋ /--0.802 mSv for group B; X-ray absorption dosage were both significant lower than that of group C （P;0.05）. Conclusion： X-ray absorption dosage of Flash Cardio SAFIRE scanning mode and DS_CoronaryCTA_AdaptSeq scanning mode is much lower than that of the DS_CoronaryCTA_SAFIRE scanning mode, but the coronary images quality were helpful for diagnosis.