第三代双源CT血管成像在急性胸痛患者扫描参数优化研究

Optimized triple rule-out CT angiography in acute chest pain using the third generation of dual source CT

目的:探讨第三代双源CT在急诊胸痛患者CTA临床应用和图像质量分析。方法:选取2018年1月至2018年7月,急诊胸痛患者210例,均行全主动脉CTA检查。按扫描时监测心率分为低心率组109例A组(<80次/min)和高心率组101例B组(≥80次/min)。每一组再分为两个亚组即自由呼吸组(A1、B1)和屏气检查组(A2、B2)。评价比较各组间CTA的图像质量和图像可诊断率。结果:主动脉CTA平均曝光时间(0.9±0.16)s,平均辐射剂量(2.32±0.48)mSv。主动脉图像质量评分A组(1.06±0.11),B组(1.08±0.15),差异无统计学意义(P>0.05)。自由呼吸亚组(1.04±0.07)与屏气检查亚组(1.10±0.05)比较差异无统计学意义(P>0.05)。肺动脉图像质量评分A组(1.2±0.19),B组(1.25±0.28)差异无统计学意义(P>0.05)。自由呼吸亚组(1.26±0.31)与屏气检查亚组(1.16±0.17)比较差异无统计学意义(P>0.05)。冠状动脉图像质量评分A组(1.67±0.65)B组(2.48±0.69)差异有统计学意义(P<0.05)。A1组(1.68±0.58)与A2组(1.65±0.72)比较差异无统计学意义(P>0.05)。各组血管内平均CT值,信噪比之间差异无统计学意义(P>0.05)。结论:第三代双源对于急诊胸痛患者提供一站式成像解决方案。由于时间分辨率提高,在自由呼吸状态下不降低扫描的图像质量。但对于高心率患者,图像质量较低心率组有一定下降。

Objective:To explore the clinical application and image quality analysis of computed tomography angiography(CTA)in patients with flash dual-source CT emergency chest pain.Methods:A total of 210 patients with acute chest pain underwent aortic CTA from January 2018 to July 2018 were enrolled.According to the heart rate(HR),109 patients with HR<80 beats/min were included in low heart rate group(group A),101 patients with HR≥80 beats/min were included in high HR group(group B).Each group was subdivided into two subgroups,the free breathing group(A1,B1)and the breath holding group(A2,B2).The image quality and diagnostic value of CTA between groups were compared.Results:The average exposure time of aortic CTA was(0.9±0.16)s.The mean effective dose was(2.32±0.48)mSv.There was no significant difference in image quality score of the aorta between group A(1.06±0.11)and group B(1.08±0.15)(P>0.05).There was no significant difference in image quality between the free breathing subgroup(1.04±0.07)and the breath holding subgroup(1.10±0.05)(P>0.05).There was no significant difference in image quality score of the pulmonary artery between group A(1.2±0.19)and group B(1.25±0.28)(P>0.05).There was no significant difference between the free breathing subgroup(1.26±0.31)and the breath holding subgroup(1.16±0.17)(P>0.05).Coronary image quality scores were significantly different between group A(1.67±0.65)and group B(2.48±0.69)(P<0.05).There was no significant difference between the A1 group(1.68±0.58)and the A2 group(1.65±0.72)(P>0.05).There was no significant difference in the mean CT value and the signal-to-noise ratio among the groups(P>0.05).Conclusions:The third generation dualsource CT provides a one-stop imaging solution for patients with acute chest pain.Since the temporal resolution is improved,the image quality in free breathing group is comparable with that of breath holding group.Coronary image quality in patients with high HR was lower than that of low HR group.