摘要
目的探讨双源CT前瞻性与回顾性心电门控冠状动脉成像的辐射剂量与图像质量的差异。方法临床可疑冠心病3组150例,每组50例,分别行Flash模式扫描、心电触发序列扫描及回顾性螺旋扫描,得到原始图像进行重建,获得MIP、CPR和VR图像。由2名经验丰富的医师依据美国心脏病学会冠状动脉树的15段分段法评价标准,对3组图像质量评分进行比较,采用Kappa检验,检验2名医师判断的一致性。采用F检验比较3组图像的CT剂量指数、剂量长度乘积、有效辐射剂量、信噪比、对比噪声比的差异。结果 2名评价者对图像质量评分的一致性较好(Kappa=0.65,P<0.05)。3组患者的冠状动脉评分优良的节段数分别为730、730、737段,所占所有评价冠状动脉比例分别为97.7﹪、97.6﹪、98.1﹪,3组差异无统计学意义;3组患者的CTDIvol分别为(2.92±0.51)mGy、(33.99±8.37)mGy、(56.59±9.89)mGy,差异有统计学意义(F=1435,P<0.01);DLP分别为(55.3±9.51)mGy·cm、(465.06±113.24)mGy·cm、(901.14±142.21)mGy·cm,差异有统计学意义(F=1322.53,P<0.01);ED分别为(0.77±0.13)mSv、(6.51±1.59)mSv、(12.62±1.99)mSv,差异有统计学意义(F=1191.60,P<0.01)。3组患者图像的SNR分别为6.66±1.16、6.42±1.07、7.05±1.09,差异无统计学意义(F=1.42,P>0.05);CNR分别为3.96±1.68、4.20±1.12、4.62±1.17;差异无统计学意义(F=1.22,P>0.05)。结论双源CT前瞻性心电门控扫描方式辐射剂量明显小于回顾性心电门控扫描,前瞻性心电门控扫描方式中Flash模式扫描辐射剂量明显小于心电触发序列扫描,三者均可获得满足临床诊断需要的、满意的图像质量。
Objective To compare the image quality and radiation dose between prospective and retrospective ECG-gated Dual-source CT coronary angiography. Method 150 patientssuspected to have coronary heart disease（CHD）were recruited and divided into three groups（50 cases in each group）. CT coronary angiography was performed on each group with Flash mode EEG triggering mode, and retrospective spiral mode, respectively. MIP, CPR and VR images were reconstructed using volume rendering, curved planar reconstruction and multiplanar reconstruction. Two experienced doctors evaluated the images according to the American Heart Association＇s 15-segment coronary artery treestandard. The Kappa test was performed for the consistency between two physicians. F-test was performed for the differences between CT dose index, length of dose index, effective radiation doses, the signal to noise ratio and contrast to noise ratio. Results A good consistency was found between two physicians（Kappa = 0.65, P 0.05）. Among three group of patients the numbers of good coronary artery segments were 730, 730, 737, respectively, which means a percentage of 97.7 ﹪, 97.6 ﹪, 98.1 ﹪, respectively. No statistically significant difference were found between three groups. CTDIvol of three groups were（2.92 ± 0.51）mGy,（33.99 ± 8.37）mGy,（56.59 ± 9.89）mGy, respectively. The difference was statistically significant（F = 1435, P 0.01）; DLP were（55.3 ± 9.51）mGy·cm,（465.06 ± 113.24）mGy·cm,（901.14 ± 142.21）mGy·cm, the difference was statistically significant（F = 1322.53, P 0.01）; ED were（0.77 ± 0.13）m Sv,（6.51 ± 1.59）m Sv,（12.62 ± 1.99）m Sv; The difference was statistically significant（F = 1191.60, P 0.01）. Three groups of patients with the SNR of image were（6.66 ± 1.16）,（6.42 ± 1.07）,（7.05 ± 1.09）; There was no statistically significant difference（F = 1.42, P 1.42）; CNR were（3.96 ± 1.68）,（4.20 ± 1.12）,（4.62 ± 1.17）; There was no statistically significant difference（F = 1.22, P 1.22）. Conclusions The radiation dosage of dual-source Prospective ECG-gated scanning mode was lower than retrospective ECG-gated mode; and the radiation dosage of FLASH mode scanning was lower than EEG-Trigger sequence.Satisfactory image quality can be realized by any of the imaging methods.
出处
《功能与分子医学影像学（电子版）》
2015年第3期27-31,共5页
Functional and Molecular Medical Imaging(Electronic Edition)
