4D多时相重组和心电编辑提高CT冠状动脉成像质量的研究

Study of 4D-multi-temporal phase reconstruction and ECG-editing in the improvement of image quality of coronary CT arteriography

目的:探讨4D多时相及心电编辑后处理方法对CT冠状动脉成像图像质量的影响。方法:采用128层螺旋CT对41例检查过程中出现心律失常、屏气不足的患者进行扫描,利用4D多时相和/或心电编辑对原始图像数据进行重组,分析不同种类心律失常患者图像在利用不同图像重组方法前后图像质量的差异。结果:出现心律失常的35例患者中:窦性心律不齐17例、房性心律不齐10例、室性心律不齐8例,35例患者在未行4D多时相和心电编辑重组处理前图像质量均≤3分且无法达到临床诊断需要,采用4D多时相和/或心电编辑重组方法后图像质量明显增加,差异有统计学意义(F=68.453,P<0.05),且同时采用4D多时相和心电编辑重组方法的的图像质量最高。6例屏气不足的患者经4D多时相重组后其图像质量均≥4分。结论:128层螺旋CT特有的4D多时相及心电编辑重组方法可明显提高扫描中出现心律失常或屏气不足的受检者的冠状动脉成像图像质量,提高检查成功率,降低检查重复率。

Objective：To study the effect of 4D multi-temporal phase reconstruction and ECG editing post-processing technique in the image quality of coronary CT arteriography （CTA）. Methods： Coronary CTA using a 128-slice spiral CT system was performed in 41 cases,cardiac arrhythrnia and breath-hold deficient appeared during examination. Post-process- ing of the raw data using 4D multi-temporal phase and/or ECG editing reconstruction techniques were done, the image quali- ties of patients with various kinds of arrhythmia before and after using different image reconstruction methods were ana- lyzed. Results：Of the 35 cases with arrhythmia,there were sinus arrhythmia （17 cases）,atrial arrhythmias （10 cases）,and ventricular arrhythmia （8 cases）. The score of evaluating image quality in these 35 cases with arrhythmia before ECG edi- ting and 4D multi-temporal phase reconstruction were ≤3 ,which could not meet the requirement of clinical diagnosis. The image quality was obviously improved after 4D multi-temporal phase and/or ECG editing reconstruction, with significant statistic difference （F= 68. 453, P〈0.05）. The image quality of 4D multi-temporal phase reconstruction in combination with ECG editing simultaneously was the best. The image quality of 6 cases with breath-hold deficient and post-processed by 4D multi-temporal reconstruction had the score ≥4 points. Conclusion：The image quality of coronary CTA in arrhythmia or breath-holding deficient subjects could be significantly improved by using ECG-editing and 4D multi-temporal phase recon- struction installed in 128-slice spiral CT system,the success rate of examination increased and the repetition rate reduced.