高心率患者低电压冠状动脉双源CTA临床应用研究

Clinical Application of Coronary Angiography Performed with Low-voltage Dual Source CT in High Heart Rate Patients

目的评价高心率患者低电压冠状动脉双源CT血管造影(computer tomographic angiography,CTA)技术的可行性。方法回顾邛崃市医疗中心医院2012年4月至2014年12月行冠状动脉双源CTA检查者资料,在使用100kV管电压、前瞻性心电门控技术进行扫描的患者中,将心率>70次/min患者(A组,n=20)与随机抽取的心率≤70次/min患者(B组,n=20)的影像资料进行比较分析,评价指标包括冠状动脉节段成像质量和辐射剂量。结果两组患者冠状动脉节段图像可诊断率分别为96.48%、97.55%,优良率分别为88.73%、91.26%,差异无统计学意义(P>0.05);容积剂量指数(CTDIvol)、有效辐射剂量(ED)和剂量长度乘积(DLP)比较,A组为(18.56±2.98)mGy、(2.18±0.53)mSv、(251.32±39.54)mGy·cm,B组为(19.24±3.10)mGy、(2.21±0.48)mSv、(265.48±40.21)mGy·cm,差异无统计学意义(P>0.05)。结论低电压冠状动脉双源CTA前瞻性心电门控扫描可用于心率>70次/min患者的检查,能够满足高血压患者临床诊断的要求。

Objective To evaluate the feasibility of coronary CTA（computer tornographic angiography） with low-voltage dual-source CT technique on high heart rate patients. Methods 20 coronary CTA images of high heart rate（〉70bpm, group A） patients were analyzed retrospectively with other 20 low heart rate（≤70bpm, group B） patients randomly selected from our hospital during the period from April 2012 to December 2014. All the CTA examinations were performed with Siemens Somatom Definition Flash dual-source CT under the tube voltage of 100 kV and prospective ECG gating technique. The qualities of coronary segments and radiation doses were compared between the two groups. Results The acceptance rate and qualified rate of coronary segment images were 96.48 %, 97.55 % and 88.73 %, 91.26 % respectively in group A and B, with no statistically significant differences between the two groups（P〉0. 05）. The CTDIvol （volume CT dose index）, ED（ effective dose） and DLP（dose length produet） were （18.56±2.98）mGy,（2.18±0.53）mSv,（251.32±39.54）mGy · cm and （19.24±3.10）mGy, （2.21 ±0.48）mSv, （265.48±40.21）mGy · cm respectively. No statically significant differences of radiation dose were found between the two groups either（P〉0.05）. Conclusions 100 kV tube voltages can be used in the technique of dual-source CT coronary angiography combined with prospective ECG gating for patient whose heart rate was more than 70bpm.