前瞻性心电门控扫描在冠脉支架随访中的应用

Feasibility of coronary artery angiography using prospective ECG-triggering acquisition in the following-up of patients with coronary artery stents

目的探讨前瞻性心电门控扫描在冠状动脉支架随访中的可行性。方法 77例冠状动脉支架植入术后患者行冠状动脉CT血管成像检查,按照心率不同分为两组,分别采用回顾性心电门控及前瞻性心电门控扫描。比较两组图像支架内及支架近端的CT值、噪声、信噪比(SNR)、支架内CT值净增比(SAIR)、图像质量主观评分及辐射剂量。定量数据表示为平均数±标准差。结果回顾性心电门控组的心率快于前瞻性心电门控组(P <0. 05)。两组图像支架内及支架近端的CT值、噪声、信噪比(SNR)、支架内CT值净增比(SAIR)以及图像质量主观评分差异均无统计学意义(P>0. 05)。前瞻性心电门控组辐射剂量显著降低,平均有效辐射剂量为(2. 40±0. 99) m Sv,组间差异具有统计学意义(P <0. 05)。结论对于冠脉支架植入术后的患者,前瞻性心电门控扫描方案在降低辐射剂量的同时,可获得满意的图像质量。

Objective To explore the feasibility of prospective ECG-triggering acquisition in the following-up of patients with coronary artery stents. Methods 77 patients with coronary stents underwent CT coronary angiography. They were scanned by retrospective and prospective ECG-triggered acquisition,respectively. Enhancement,noise,signal-to-noise（SNR）,SAIR,image quality scores,radiation dose of inner-stent and the coronary artery proximal to the stents were compared. Quantitative data were expressed as means ± standard deviations. Results The heart rates were higher in retrospective group than those in prospective group（P〈0. 05）. There was no statistically significant difference in enhancement,noise,signal-to-noise（SNR）,SAIR,image quality scores between the two groups（P〉0. 05）. Effective dose（ED） in prospective group was（2. 40 ± 0. 99） m Sv.There was significant reduction in prospective group than that in retrospective group（P〈0. 05）. Conclusion In the patients with coronary stents,coronary artery angiography performed by prospective ECG-triggered acquisition may obtain the diagnostic image with significant reduction of radiation dose.