高时间分辨率宽体探测器CT对心律失常患者冠状动脉CTA的可行性研究

Feasibility of the Coronary CTA Examinations for Arrhythmia Patients by Using High Temporal Resolution Wide-Area Detector CT

目的探讨高时间分辨率宽体探测器CT应用于心律失常患者冠状动脉CT造影(Coronary Computed Tomography Angiogram,CCTA)的可行性。方法选取120例疑诊冠心病行CCTA检查的患者,分为A、B两组,每组各60例。其中B组为心律正常组,A组为心律失常组。记录患者体重指数(Body Mass Index,BMI)、CT值(HU)、客观噪声(SD)及辐射剂量(Coronary Computed Tomography Angiogram,DLP)。开启智能期相技术自动选取最佳期相,经冠状动脉追踪冻结技术处理后对最佳期相图像进行三维后处理及主观评分。结果两组BMI、CT值、SD均无统计学差异(P>0.05)。B组中8例患者的心率>100次/min,A组患者中共有房颤46例,各类型早搏12例,二联律2例。两组患者三维重建图像的主观评分无统计学差异(P>0.05)。A、B两组患者有效辐射剂量(ED)比较具有统计学差异。其中A组为(3.15±0.12)msv,B组为(2.55±0.12)msv。结论高时间分辨率宽体探测器CT可应用于心律失常患者的CCTA检查,并且可以获得满意的图像质量。

Objective Our study focused on discuss the feasibility of the coronary CTA examinations for the arrhythmia patients by using high temporal resolution wide-area detector CT. Methods A total of 60 patients with arrhythmia（Group A） and 60 patients with sinus heart rate（Group B） were enrolled and underwent coronary CTA examinations by using new generation wide-detector row CT scanner. Auto selection of optimum cardiac phase technique was used to select a series of axial image with least motion artifact. Coronary artery tracing technique was then used to reconstruct the 3 D reconstructed images which were then analyzed in AW 4.6 work station. Body mass index（BMI）, heart rate（HR）, CT value（HU）, objective noise（SD）, dose-length product（DLP） values were recorded. Subjective and objective image quality were evaluated. Results The two groups matched in BMI, HU and SD values（P〉0.05）. Group A owned 8 cases with HR 〉 100 bpm while group B owned 46 cases of atrial fibrillation, 12 cases of premature beat and 2 cases of bigeminy coupled rhythm. Subjective evaluation resulted in no statistical difference（P〉0.05）. Effective radiation doses of group A was higher than that of group B（P〈0.05）. Conclusion The coronary CTA examinations for the arrhythmia patients are effective by using high temporal resolution wide-area detector CT, with high image quality.