320排CT前瞻性心电门控在心肺血管一站式扫描中的应用

Prospective ECG gating for triple rule-out CT angiography in assessment ofacute chest pain

目的评价320排CT前瞻性心电门控心肺血管一站式成像在急性胸痛检查中的应用。方法对170例心率≤70次/min的心肺血管一站式成像影像资料进行分析,病例分为前瞻性心电门控的前瞻组(P组)和回顾性心电门控的回顾组(R)。重建所有病例冠状动脉、肺动脉、胸主动脉图像,评价图像质量并完成诊断,同时比较分析2组图像质量和辐射剂量。结果 2组满足管腔评价的血管段比例差异无统计学意义(P>0.597)。前瞻组和回顾组肺动脉[分别为(383.00±53.64)、(366.48±60.96)HU]、冠状动脉[分别为(426.31±79.75)、(407.49±91.00)HU]、胸主动脉[分别为(416.53±63.44)、(413.58±58.62)HU]、图像噪声(分别为20.46±5.84、18.55±4.67)、信噪比(分别为22.06±6.47、23.13±5.76)、对比噪声比(分别为15.12±5.43、15.92±4.77)差异均无统计学意义,2组有效剂量分别为(11.85±3.90)、(20.06±3.27)m Sv,其差异有统计学意义(P<0.01)。结论前瞻性心电门控心肺血管一站式扫描能有效降低辐射剂量并保证诊断图像质量。

Objective To evaluate triple rule-out CT angiography with prospective ECG-gated 320-detector CT in patients with acute chest pain. Methods Total 170 patients with heart rate ≤70 bpm undergoing triple rule-out CT angiography were divided into group P（ prospective ECG gating） and group R（ retrospective ECG gating）. The images of the coronary arteries,pulmonary artery and thoracic aorta were reconstructed in all patients. All images were processed for image analyses and compared between the two groups. Results No significant difference was showed in the ratio of acceptable segments between two groups. There was no significant difference in CT values ofpulmonary artery [（ 383. 00 ± 53. 64） HU vs.（ 366. 48 ± 60. 96） HU],coronary artery [（ 426. 31 ± 79. 75） HU vs.（ 407. 49 ± 91. 00） HU ],thoracic arteries[（ 416. 53 ± 63. 44） HU vs.（ 413. 58 ± 58. 62） HU],noise [（ 20. 46 ± 5. 84） vs.（ 18. 55 ± 4. 67） ],SNR [（ 22. 06 ±6. 47） vs.（ 23. 13 ± 5. 76） ],CNR [（ 15. 12 ± 5. 43） vs.（ 15. 92 ± 4. 77） ],respectively. However,the significance was found in ED（ t =- 9. 41,P〈0. 01）. Conclusion Low dose and diagnostic image quality can be achieved with prospective ECG-gated triple rule-out CT angiography.