前瞻性心电触发单次心跳冠状动脉CT血管造影的可行性和辐射剂量研究

Study of the feasibility and radiation dose of coronary CT angiography of prospective ECG triggered singleheartbeat

目的:研究房颤(AF)患者应用前瞻性心电触发单次心跳冠状动脉CT血管造影(CCTA)检查的可行性,比较AF患者与窦性心律(SR)患者CCTA检查的图像质量和辐射剂量。方法:前瞻性选取临床疑诊的40例冠心病患者,将在CCTA检查过程中出现的20例连续AF患者纳入AF组,将20例SR患者纳入SR组。CT扫描采用前瞻性心电触发单次心跳扫描模式,管电压120 kV,自动毫安(automatic mA)。对两组CCTA图像噪声、信噪比(SNR)及对比噪声比(CNR)进行客观评估,并对冠状动脉图像质量进行主观评估;计算和比较两组患者检查的有效辐射剂量。结果:AF组的图像噪声、CNR和SNR分别为(28.7±5.8)、(18.4±5.1)和(15.2±4.4);SR组分别为(29.1±5.6)、(18.5±6.6)和(15.4±5.9),两组比较差异无统计学意义。AF组和SR组患者的主观图像质量评分分别为(1.6±0.7)分和(1.5±0.6)分,两组比较差异无统计学意义;AF组和SR组冠状动脉血管段的主观评分分别为(1.16±0.4)分和(1.24±0.5)分,两组比较差异有统计学意义(Z=-2.349b,P<0.05)。AF组和SR组平均有效辐射剂量分别为(3.5±1.1)mSv和(2.9±1.2)mSv,两组比较差异无统计学意义。结论:AF患者应用宽体探测器CT单次心跳CCTA成像可获得与SR患者较一致的成功率和良好的图像质量,两者的有效辐射剂量大致相同。

Objective:To study the feasibility of coronary computed tomography angiography(CCTA)examination of prospective ECG triggered single-heartbeat on patients with atrial fibrillation(AF),and to compare the image quality(IQ)and radiation dose of CCTA examination between AF patients and patients with sinus rhythm(SR).Methods:40 patients with coronary heart disease(CHD)who were suspected cases were prospectively selected,and 20 successive patients with AF were divided into AF group and 20 patients with SR were divided into SR group in the CCTA examination.The prospective ECG triggered single-heartbeat scanning mode was adopted in CT scan,and the tube voltage was 120kV,and the electric current was automatic mA.The image noise,signal-to-noise radio(SNR)and contrast-to-noise ratio(CNR)of CCTA images between the two groups were objectively assessed.And the IQ of coronary artery was subjectively assessed,and the effective radiation doses of examination on patients of two groups were calculated and compared.Results:The image noise,CNR and SNR of group AF were(28.7±5.8),(18.4±5.1)and(15.2±4.4),and those of group SR were(29.1±5.6),(18.5±6.6)and(15.4±5.9),and the differences of these between two groups were no significant.And the difference of subjective IQ score between group AF(1.6±0.7)and group SR(1.5±0.6)was no significant.The difference of subjective score of blood vessel segment of coronary artery between group AF(1.16±0.4)and group SR(1.24±0.5)was significant(Z=-2.349b,P<0.05).And the difference of averagely effective dose between group AF(3.5±1.1 mSv)and group SR(2.9±1.2mSv)was no significant.Conclusion:Patient with AF uses single-heartbeat CCTA of wide-detector CT can obtain consistently success rate and favorable IQ with patient with SR,and effective radiation doses of two groups are almost identical.