二代双源CT MinDose技术与超声心动图在主动脉瓣狭窄术前评估中的对比研究

Comparison between second-generation dual-source computed tomography angiography with MinDose sequence and echocardiography for preoperative evaluation of aortic stenosis patients

目的采用双源CT的MinDose技术(MD-DSCT)及二维超声心动图分别评价并比较主动脉瓣狭窄患者的冠状动脉、瓣环直径及心功能。方法回顾性分析33例欲行换瓣治疗的主动脉瓣狭窄患者。MD-DSCT检查仅于全RR间期的10%间期全剂量曝光,于70%RR间期双斜轴向图像重建。超声心动图及MD-DSCT采分别测量左室射血分数(LVEF)和主动脉瓣环直径(AVAD)。结果所有患者MD-DSCT检查评价冠状动脉均获得良好效果。LVEF-2D与LVEF-MD-DSCT有较强的相关性(r=0.96,P<0.01)。AVAD-2D与AVAD-MD-DSCT有较强的相关性(r=0.91,P<0.01)。结论 MD-DSCT可以于术前一站式评价主动脉瓣狭窄患者的冠状动脉、LVEF以及AVAD。

Objective The purpose of this study was to assess and compare coronary artery,AVAD and LVEF of aortic stenosis patients using MinDose sequence of DSCT and 2D-TTE before operation.Methods Thirty-three patients suspected for aortic valve disease underwent MD-DSCT to observe coronary artery,AVAD and LVEF.Of MD-DSCT,the full tube current time window was applied only 10% RR interval,the minimal tube current（4%）was used in all other parts of the cardiac cycle.Images were reconstructed at 70%of RR interval and analyzed by using double oblique reconstruction.Results In all 33 patients,MinDose technique successfully evaluated coronary artery.There was a strong correlation between LVEF-MD-DSCT and LVEF-2D（r=0.96,P〈0.01）.There was also a strong correlation between AVAD-MDDSCT and AVAD-2D（r=0.91,P〈0.01）.The CTDIvol,DLP,as well as ED of the experimental group differed significantly from those of the control group（P〈0.01）.Conclusion As an one-stop preoperative evaluation,MinDoseDSCT can comprehensively reflect the coronary,AVAD and LVEF of aortic stenosis patients.