心电脉冲技术用于胸痛三联征-CT血管造影

Electrocardiogram-pulsing technique used in triple-rule-out-CT angiography

目的观察心电脉冲技术用于胸痛三联征(TRO)-CT血管造影(CTA)的价值。方法前瞻性收集96例因急性胸痛接受TRO-CTA检查患者,根据不同扫描方式及心率分为A1组(后门控技术扫描,心率<70次/分)、A2组(后门控技术扫描,心率≥70次/分)、B1组(心电脉冲技术扫描,心率<70次/分)和B2组(心电脉冲技术扫描,心率≥70次/分),每组24例。比较A1与B1组、A2与B2组间主动脉、肺动脉干及冠状动脉主要分支图像主观评分及客观评价结果的差异,并计算有效剂量(ED)。结果A1组与B1组间、A2组与B2组间,图像质量主观评分差异均无统计学意义(P均>0.05)。B1组主动脉及肺动脉干信噪比(SNR),主动脉、肺动脉干及冠状动脉主要分支对比噪声比(CNR)均高于A1组(P均<0.05),而冠状动脉主要分支SNR与A1组差异均无统计学意义(P均>0.05);A2组与B2组间比较结果同上。B1组ED[(4.67±0.45)mSv]显著低于A1组[(13.64±1.60)mSv,P<0.05],B2组ED[(5.17±0.49)mSv]显著低于A2组[(13.24±2.12)mSv,P<0.05]。结论心电脉冲技术用于TRO-CTA检查可提高图像分辨率,显著降低ED。

Objective To observe the application value of electrocardiogram(ECG)-pulsing technique for triple-rule-out(TRO)-CT angiography(CTA).Methods Totally 96 patients who underwent TRO-CTA due to acute chest pain were prospectively enrolled.According to scanning mode and heart rate,the patients were divided into A1(later gated scanning,heart rate<70 beats/min),A2(later gated scanning,heart rate≥70 beats/min),B1(ECG-pulsing scanning,heart rate<70 beats/min)and B2 groups(ECG-pulsing scanning,heart rate≥70 beats/min)(each n=24).The subjective score and objective evaluation results of aorta,pulmonary trunk and major branches of coronary artery were compared between A1 and B1 groups as well as between A2 and B2 groups,and the effective dose(ED)were caculated.Results There was no significant different of subjective scores of imaging quality between A1 and B1 groups,nor between A2 and B2 groups(all P>0.05).The signal-to-noise ratio(SNR)of aorta and pulmonary trunk,contrast-to-noise ratio(CNR)of aorta,pulmonary trunk and main branches of coronary artery in B1 group were higher than those in A1 group(all P<0.05),while no significant different of SNR of main branches of coronary artery was found(all P>0.05).The results between A2 group and B2 group were the same as those of A1 group and B1 group.ED of B1 group([4.67±0.45]mSv)was significantly lower than that of A1 group([13.64±1.60]mSv,P<0.05),and that of B2 group([5.17±0.49]mSv)was significantly lower than that of A2 group([13.24±2.12]mSv,P<0.05).Conclusion ECG-pulsing technique used in TRO-CTA could improve image resolution and significantly reduce ED.