单一时相前瞻性心电门控CT冠状动脉成像的临床应用

Clinical Application of CT Coronary Artery Imaging with Single Phase Prospective ECG-gating

目的:评价单一时相前瞻性心电门控冠状动脉成像临床应用的可行性。方法:回顾性分析134例临床疑似冠心病患者CT冠状动脉造影(CTCA)图像,所有检查均采用前瞻性心电门控,曝光补偿时间设为0ms。以有创X线冠状动脉造影(CAG)结果为金标准进行对照,对图像质量进行评估。评估CTCA在冠状动脉节段水平对冠状动脉狭窄病变的显示情况,及其诊断管腔狭窄(狭窄程度≥50%)的准确性。结果:CTCA对冠心病诊断的敏感性、特异性、阳性预测值和阴性预测值分别为:94.16%、97.42%、88.69%及98.73%。图像质量评分:4分93例,3分41例,无1、2分者。有效辐射剂量(ED)均值为1.44m Sv。结论:单一时相前瞻性心电门控CT冠状动脉成像,严格控制心率在65次/分以下扫描,能够得到满足诊断的图像,且能够明显降低受检者的有效辐射剂量。

Purpose： To assess the possibility of the clinical application of coronary artery imaging with single phase prospective ECG-gating. Methods： One hundred and thirty-four cases of patients with suspected coronary heart disease examed by CT coronary angiography （CTCA） prospectively ECG-gating scanning were enrolled. The exposure compensation time was set to 0 ms. The traditional coronary angiography （CAG） was considered as the golden standard. The ability and accuracy of CTCA in diagnosing coronary heart disease （coronary artery stenosis _〉50~o ） on per-segment level was evaluated. Results： The sensitivity, specificity, positive predictive value and negative predictive value of CTCA for diagnosing coronary heart disease were 94.16%, 97.42%, 88.69% and 98.73% respectively. The results of image quality scores were as follows： 93 cases of 4 points, 41 cases of 3 points, and none of i and 2 points. Mean effective radiation dose was 1.44 mSv. Conclusion： Coronary artery imaging in single phase prospective ECG-gating can get high quality image to diagnose coronary heart disease, when the heart rate is strictly below 65beat/min. And the effective radiation dose of the subjects is significantly reduced.