大螺距联合三低方案对冠心病患者行冠状动脉CTA检查的可行性分析

Feasibility analysis of coronary artery CTA examination in patients with coronary heart disease by large pitch combined with three-low regimen

目的探讨大螺距联合低管电压、低剂量对比剂、低流速条件下对冠心病患者行冠状动脉CT血管成像检查的可行性。方法选取进行冠状动脉CTA检查的冠心病患者158例,随机均分为两组,A组采用常规前瞻性心电门控扫描;B组采用低管电压、低剂量对比剂、低流速前瞻性心电门控大螺距扫描;检查完成后重建并传至后处理工作站,对图像质量进行总体评分。记录平均容积CT剂量指数(CTDIvol)和剂量长度乘积(DLP),计算有效剂量(ED)。结果两组左、右冠状动脉开口处管腔及升主动脉根部管腔、左心室底部肌肉增强后的强化CT值、SI、SD、SNR、CNR比较差异均无统计学意义。A、B组图像质量评分比较P0.05。B组CTDIvol、DLP及ED均低于A组(P均<0.01)。结论冠心病患者在前瞻性门控大螺距联合低管电压、低剂量对比剂、低流速条件下行冠状动脉CTA检查,可获得满足诊断需求的高质量图像,且辐射剂量降低。

Objective:To discuss the feasibility of lower tube voltage and low dose of iodine-concentration contrast material,low velocity of flow injection in dual-source CT prospective ECG-trigger high pitch to scan for coronary artery imaging.Methods:The patients with coronary heart disease(CHD)who had coronary CTA examination were selected and 158 cases were divided into two groups at random.Conventional prospective electrocardiographic scanning was used in Group A.Low tube voltage,low dose of iodine concentration contrast material and low velocity of flow injection prospective gated controlled high pitch scanning were adopted in Group B.The following data,including image quality,CT Value,SNR,CNR and radiation dose were analyzed between two groups.Mean volume CT dose index(CTDIvol),dose length product(DLP)and effective dose(ED)were recorded.Results:There were no statistically significant differences in enhanced CT value,SI,SD,SNR and CNR of the left and right coronary artery opening lumen,the lumen at the root of the ascending aorta,and the muscle enhancement at the bottom of the left ventricle between the two groups.Conclusion:Coronary artery CTA examination in patients with coronary heart disease under the condition of prospective gated large pitch combined with low tube voltage,low dose contrast agent and low flow rate can obtain high-quality images that meet the diagnostic requirements and reduce the radiation dose.