改良电极放置方案在冠状动脉CT血管成像检查的可行性研究

Feasibility Study of Improved Electrode Placement Scheme in Coronary CT Angiography

目的比较不同电极放置位置对心电监护图形及冠状动脉CT血管成像(coronary CT angiography,CCTA)图像质量的影响。方法将2019-09/2020-09月接受CCTA检查的70例患者纳入本研究,并随机分为常规电极放置组和改良电极放置组,每组各35例。常规电极放置组将电极贴于左、右锁骨中线第二肋间及左侧肋弓下缘以下部位区域;改良电极放置组将电极贴于左、右前臂皮肤裸露区域及左侧锁骨中线与肋弓下缘以下部位区域。两组患者扫描参数及对比剂注射方案均一致,比较两组患者心电监护图形质量、图像噪声、信噪比(signal-to-noise ratio,SNR)、有效辐射剂量和主观评分。结果两组患者的主观图像质量评分均满足诊断需求。两组患者的图像噪声、SNR、有效辐射剂量差异均无统计学意义(P>0.05);但改良电极放置组患者的心电监护图形清晰概率(100%)优于常规电极放置组(82.86%),组间比较差异有统计学意义(P<0.05)。结论改良电极放置方案不仅可得到与常规电极放置方案同等质量的CCTA图像,有效辐射剂量无增加,还可获得更稳定、可靠的心电监护图形,保护患者隐私安全。

Objective To compare the effects of different electrode positions on the image quality of electrocardiogram monitoring chart and coronary CT angiography(CCTA).Methods A total of 70 patients underwent CCTA from September 2019 to September 2020 were included in this study.The patients were randomly divided into the conventional electrode placement group and the modified electrode placement group,with 35 cases in each.The electrode was attached to the second intercostal area of the left and right clavicle midline and the area below the lower edge of the left costal arch in conventional electrode placement group;the electrode was attached to the exposed area of the left and right forearm skin and the area below the left clavicle midline and the lower edge of the costal arch in the modified electrode placement group.The scanning parameters and contrast injection protocol of the two groups were consistent and the quality of electrocardiogram monitoring chart,image noise,signal-to-noise ratio(SNR),effective radiation dose and subjective score of the two groups were compared.Results The subjective image quality scores of the two groups met the needs of diagnosis.The image noise,SNR and effective radiation dose of the two groups had no statistical significance(P>0.05),however,the clear probability of electrocardiogram monitoring graph(100%)of the modified electrode placement group was better than that of the conventional electrode placement group(82.86%),and the difference was statistically significant(P<0.05).Conclusion The improved electrode placement scheme can not only obtain the same quality of CCTA images as the conventional electrode placement scheme,but also obtain more stable and reliable electrocardiogram monitoring chart without increasing the effective radiation dose,which can protect the privacy and safety of patients.