冠状动脉扫描参数在“一站式”胸痛三联征CT血管造影检查的应用

Application of coronary artery scanning parameters in one-stop CT angiography of chest pain triad

目的 探讨冠状动脉(冠脉)扫描参数在“一站式”胸痛三联征CT血管造影(CTA)检查中的应用价值。方法 通过扩大扫描范围和改变对比剂注射方式实现胸痛三联征CTA“一站式”检查,利用冠脉CTA扫描参数获得图像(A组,30例),采用主观和客观评价将其与常规单独CTA扫描图像(B组,93例)的质量进行对比分析。B组中包括肺动脉CTA(B1组)、主动脉CTA(B2组)和冠脉CTA(B3组),每组31例。结果 由诊断医师进行主观评价,A组、B1组、B2组和B3组图像质量评分均无统计学差异(P>0.05)。通过测量数值进行客观评价,A组和B1组左、右肺动脉CT值均无统计学差异(P>0.05),A组肺静脉CT值和主动脉CT值均大于B1组(P<0.05或P<0.01);A组主动脉CT值大于B2组(P<0.01);A组和B3组肺静脉CT值、主动脉CT值和左、右冠脉CT值均无统计学差异(P>0.05)。A组有效辐射剂量仅为B组的43%。结论 利用冠脉CTA扫描参数实现胸痛三联征CTA“一站式”检查肺动脉、主动脉、冠脉的图像质量符合诊断要求,且能有效降低辐射剂量和对比剂用量。

Objective To explore the application value of coronary artery scanning parameters in one-stop CT angiography(CTA)of chest pain triad.Methods The CTA one-stop examination of chest pain triad was realized by expanding the scanning range and changing the contrast agent injection method.The image was obtained by the coronary CTA scanning parameters(group A,30patients).Using subjective and objective evaluation,the quality of the image was compared with that of the conventional CTA scanning(group B,93patients),which included pulmonary artery CTA(group B1,31patients),aortic CTA(group B2,31patients)and coronary CTA(group B3,31patients).Results According to the subjective evaluation of the diagnostic physician,the image quality score was not obviously different among four groups of A,B1,B2and B3(P>0.05).The objective evaluation of the measured values showed that there was no significant difference in the CT values of left and right pulmonary arteries between group A and group B1(P>0.05),the CT values of pulmonary veins and aorta in group A were higher than those in group B1(P<0.05or P<0.01),the CT value of aorta in group A was higher than that in group B2(P<0.01),and there was no significant difference in the CT values of pulmonary vein,aorta and left and right coronary arteries between group A and group B3(P>0.05).The effective radiation dose in group A was only 43%of that in group B.Conclusion The image quality of pulmonary artery,aorta and coronary artery in CTA one-stop examination of chest pain triad by coronary CTA scanning parameters can meet the diagnostic requirements and effectively reduce the radiation dose and contrast agent dosage.