多时相重建及心电编辑对冠脉CTA成像质量的作用

Effects of Multitemporal Reconstruction and Electrocardiographic Editing on Coronary CTA Imaging Quality

目的:探讨多时相重建及心电编辑对冠脉CTA成像质量的作用。方法:77例冠脉CTA检查用回顾性心电门控选择最佳相位窗及心电编辑进行图像重建,用容积再现(VRT)、曲面重建(CRP)及最大密度投影(MIP)、多平面重建(MPR)进行图像后处理,显示左右冠脉及其分支。结果:41例常规冠脉CTA扫描获得图像评分3-4分,得到优良图像;22例共198段中由于心率的变化或异常造成图像错层、扭曲伪影获得评分3-4分、2分、1分分别为63.4%、25.5%、11.1%,经心电编辑和多时相重建获得满图像评分3-4分、2分、1分分别占91.4%、6.6%、2.0%,图像评分大于等于2分的较编辑前提高了9.1%;14例共126段中因呼吸运动造成断层或错层获得图像评分3-4分、2分、1分分别为22.2%、10.7%、67.2%,通过反复多时相重建获得图像评分3-4分、2分、1分分别占24.6%、18.3%、57.1%,图像评分大于等于2分较编辑前提高了10%。结论:冠脉CTA检查能否得到具有诊断价值的图像,除去先进的设备,各检查环节之间的配合之外,多时相重建及心电编辑可以用来改善甚至消除冠脉CTA成像中出现心率和呼吸运动造成的伪影,提升图像的诊断价值。

Objective:To investigate the effect of multi-phase reconstruction and ECG editing on coronary CTA imaging quality. Methods:77 coronary CTA examinations were performed with retrospective ECG gating to select the best phase window and ECG editing for image reconstruction. Volume reconstruction(VRT) and surface reconstruction(CRP) were used for image reconstruction. And maximum intensity projection(MIP), multi-planar reconstruction(MPR) for image post-processing, showing the left and right coronary arteries and their branches. Results:The image score of 3-4 points was obtained from conventional coronary CTA scan in 41 cases, and excellent images were obtained;22 cases with a total of 198 segments caused image dislocation and distortion due to changes in heart rate or abnormality. The scores of 3-4 points, 2 points, and 1 points were 63.4%, 25.5%, and 11.1%, respectively. After ECG editing and multi-temporal reconstruction, the full image scores were 3-4 points, 2 points, and 10%. 1 points accounted for 91.4%, 6.6%, and 2.0%, respectively, and the image scores greater than or equal to 2 points increased by 9.1% compared with before editing;14 cases with a total of 126 segments caused faults or dislocations due to respiratory motion The image scores of 3-4, 2, and 1 were 22.2%, 10.7%, and 67.2%, respectively. The image scores of 3-4, 2, and 1 obtained by repeated multi-temporal reconstruction accounted for 22.2%, 10.7%, and 67.2%, respectively. 24.6%, 18.3%, 57.1%, and the image score is greater than or equal to 2 points, which is 10% higher than that before editing. Conclusion:Coronary CTA examination can obtain images with diagnostic value, in addition to advanced equipment and cooperation between various examination links, multi-temporal reconstruction and ECG editing can be used to Improve or even eliminate the artifacts caused by heart rate and respiratory motion in coronary CTA imaging, and improve the diagnostic value of the image.