双源CT心脏双期低剂量技术诊断左心耳血栓及血栓前状态的价值研究

Value of dual-source CT cardiac dual-phase low-dose technique in the diagnosis of thrombus and prethrombotic state of left atrial appendage

目的分析双源CT心脏双期低剂量技术诊断左心耳血栓及血栓前状态的价值。方法 40例拟行导管消融术的房颤患者,随机分为研究组和对照组,各20例。所有患者均行双源CT心脏双期技术扫描血栓,研究组采用低剂量扫描检查,对照组采用高剂量扫描检查。同时进行经食管超声心动图(TEE)检查,以TEE检查结果作为金标准,比较两组血栓检出情况、图像质量评分和辐射剂量。结果两组患者经TEE检查均检出7例血栓。两组患者血栓检出准确率比较差异无统计学意义(P>0.05)。研究组的图像质量评分为(4.41±0.51)分,与对照组的(4.53±0.69)分比较,差异无统计学意义(P>0.05)。研究组容积CT剂量指数(CTDIvol)为(10.81±1.27)mGy、剂量长度乘积(DLP)为(53.21±9.61)mGy·cm、有效剂量(ED)为(0.74±0.15)mSv、辐射剂量为(500.36±12.28)Gy,均明显低于对照组的(31.30±0.22)mGy、(155.53±12.46)mGy·cm、(2.36±0.28)mSv、(625.74±25.15)Gy,差异均具有统计学意义(P<0.05)。结论双源CT心脏双期低剂量技术诊断价值较高,能够在正确诊断出血栓时保证质量,降低辐射剂量,值得推广。

Objective To analyze the value of dual-source CT cardiac dual-phase low-dose technique in the diagnosis of thrombus and prethrombotic state of left atrial appendage. Methods A total of 40 patients with atrial fibrillation who were to be treated by catheter ablation were randomly divided into research group and control group, with 20 cases in each group. All patients underwent dual-source CT cardiac dual-phase technology scanning thrombus and TEE examination at the same time. The research group used low-dose scans and the control group used high-dose scans. With TEE results as the gold standard, the detection of thrombus, image quality score and radiation dose were compared between the two groups. Results 7 cases of thrombus were detected in both groups after TEE examination. There was no statistically significant difference in the accuracy of detection between the two groups(P>0.05). The image quality score of the research group was(4.41± 0.51) points, which had no statistically significant difference compared with that of the control group(4.53± 0.69) points(P>0.05). The CT dose index-volume(CTDIvol)(10.81±1.27) mGy, dose length product(DLP)(53.21±9.61) mGy·cm and effective dose(ED)(0.74±0.15)mSv and radiation dose(500.36±12.28)Gy of the research group were obviously lower than those of the control group(31.30±0.22) mGy,(155.53± 12.46) mGy·cm,(2.36±0.28) mSv and(625.74±25.15)Gy, and the difference was statistically significant(P<0.05). Conclusion Dual-source CT cardiac dual-phase low-dose technique is of high value in the diagnosis of bleeding thrombus and reduce the radiation dose, which is worthy of promotion.