第二代心脏冻结技术提升高心率先天性心脏病儿童大血管根部成像效果研究

Further improving image quality of aorta and pulmonary artery root for children with high heart rates using second-generation motion correction algorithm

目的评价第二代心脏冻结技术(motion correction 2,MC2)对提升高心率先天性心脏病(congenital heart disease,CHD)儿童心脏血管造影(cardiovascular computed tomography angiography,CCTA)主动脉根部和肺动脉根部图像质量的效果。方法42例有症状的高心率CHD患儿入组。所有患者均采用前瞻性心电门控进行CCTA扫描。图像重建分别采用第一代心脏冻结技术(motion correction 1,MC1)算法和MC2算法。由2位经验丰富的放射科医师采用4分法评价(1分:无法诊断;2分:可判断走行;3分:可测量;4分:质量好)主动脉根部和肺动脉根部的图像质量。以心率120次/min为界,将所有病例分为超高心率组(very high rates,VHR)和高心率组(high rates,HR)分别进行评价。结果患者中位年龄8个月(5天~6年),平均心率122.6±18.8(78~151)次/min。主动脉根部图像质量评分从MC1的(2.5±1.0)分提高到MC2的(3.3±0.5)分,肺动脉根部从MC1的(2.6±0.9)分提高到MC2的(3.1±0.6)分。VHR组主动脉根部评分由(2.1±0.5)分提高到(3.2±0.4)分,肺动脉根部评分从(2.5±0.9)分提高到(3.2±0.7)分(P<0.05)。HR组主动脉根部评分由(2.8±1.1)分提高到(3.4±0.6)分(P>0.05),肺动脉根部评分由(2.8±0.9)分提高到(3.0±0.6)分(P>0.05)。结论第二代心脏冻结技术进一步提升了高心率,尤其是心率大于120次/min的先天性心脏病患儿CCTA检查主动脉和肺动脉根部质量,为术前评估提供了有力支持。

Objective To evaluate the effectiveness of a second-generation motion correction algorithm in improving image quality of Aorta and pulmonary artery root in computed tomography angiography(CTA)of heart for children with high heart rates.Methods 42 consecutive symptomatic cardiac patients with high heart rates were enrolled.All patients underwent CCTA on a 256-detector row CT using prospective ECG-triggered single-beat protocol.Images were reconstructed using a state-of-the-art first-generation coronary artery motion correction(MC1)algorithm,and a second-generation whole-heart motion correction(MC2)algorithm.The image quality of Aorta and pulmonary artery root was assessed by two experienced radiologists using a 4-point scale(1:nondiagnostic;2:detectable;3:measurable and 4:perfect),according to the heart rate with 120 as the boundary,all cases were divided into very high rate group(VHR)and high rate group(HR).Results The median patient age was 8 months(5 days~6 years),and the average heart rate was 122.6±18.8(78~151)bpm.The overall image quality scores were improved to 3.3±0.5 with the use of MC2 from 2.5±1.0 with MC1 of Aorta root,and 3.1±0.6 with the use of MC2 from 2.6±0.9 with MC1 of pulmonary root.VHR group quality scores were improved to 3.2±0.4 with MC2,as compared to 2.1±0.5 with MC1 of Aorta root,and pulmonary artery root scores were improved to 3.2±0.7 from 2.5±0.9 with MC1(all P<0.05).In HR group,image quality scores were improved to 3.4±0.6 with MC2,as compared to 2.8±1.1 with MC1 of Aorta root(P>0.05),and pulmonary artery root scores were improved to 3.0±0.6 from 2.8±0.9 with MC1(P>0.05).Conclusion A second-generation whole-heart motion correction algorithm further significantly improves CTA image quality of Aorta and pulmonary artery root for pediatric cardiac patients with high heart rates,especially with heart rate higher than 120.