双源CT Doubule-Flash扫描模式在冠状动脉搭桥术后随访的临床应用

Clinical application of dual-source CT Double-Flash mode in follow-up after coronary artery bypass grafting

目的探讨双源CT Double-Flash模式在冠状动脉搭桥术(CABG)后随访中的应用价值。方法对心率≤65次/min的73例CABG受检者进行CT冠状动脉(冠脉)造影检查(CTCA)。将受检者随机分为两组,A组为普通模式组(回顾性心电门控螺旋扫描模式,35例),B组为Double-Flash模式组(大螺距前瞻性心电触发采集模式,38例);检查过程中分别记录A、B两组中两种扫描模式的图像质量、辐射剂量及对比剂使用量。结果两组CABG血管共151支,平均随访(13.3±9.7)年。普通扫描模式A组82支,图像质量评分为(1.5±0.4)分;Double-Flash扫描模式B组69支,图像质量评分为(1.6±0.6)分,差异无统计学意义(P>0.05)。A组有效辐射剂量(ED)和CT容积剂量指数(CTDIvol)分别为(16.14±3.51)msv和(39.51±6.81)mGy,B组分别为(2.91±0.87)msv和(4.43±0.71)mGy,差异均有统计学意义(P<0.01)。A组和B组对比剂一次性注射量分别为(81±14)ml与(60±8)ml,差异均有统计学意义(P<0.05)。结论双源CT Double-Flash扫描模式在CABG冠脉造影中,与普通螺旋扫描模式比较,在保证图像质量同时,可显著降低辐射剂量和对比剂使用量。

Objective To investigate the application of dual-source CT Double-Flash mode in follow-up after coronary artery bypass grafting(CABG).Methods The patients(with heart rate≤65次/min,n=73,received CABG)were given examination of CT coronary angiography(CTCA).All patients were divided into 2 groups:group A was normal mode group(received retrospective electrocardiogate-controlled spiral scanning mode,n=35),and group B was Double-Flash mode group(received large-pitch prospective electrocardiotrigger acquisition mode,n=38).During the examination,the image quality,radiation dosages and contrast agent doses of 2 scanning modes were recorded respectively in group A and group B.Results There were totally 151 CABG vessels and mean follow-up time was(13.4±7.5)y in 2 groups.There were 82 vessels of normal scanning mode,and image quality score was(1.5±0.4)in group A,and there were 69 vessels of Double-Flash scanning mode,and the image quality score was(1.6±0.6)in group B(P>0.05).Effective radiation dosage(ED)was(16.14±3.51)MSV and CT volume dose index(CTDIvol)was(39.51±6.81)mGy in group A,and ED was(2.91±0.87)MSV and CTDIvol was(4.43±0.71)mGy in group B(P<0.01).The one-time dose of contrast agent was(80±14)ml in group A and(60±8)ml in group B(P<0.05).Conclusion Dual-source CT Double-Flash mode can significantly reduce radiation dosage and dose of contrast agent while ensuring image quality during CABG coronary angiography.