基于宽体探测器行“一站式”心脑联合CTA在心律不齐患者中的可行性研究

Feasibility of"One-Stop"Combined Coronary and Craniocervical CTA in Patients with Arrhythmia Using Wide-Detector Scanner

目的:探讨心律不齐患者行冠状动脉和头颈动脉CT血管成像(CTA)联合扫描的图像质量和辐射剂量。方法:回顾性搜集了2022年1月至2022年12月期间进行冠状动脉和头颈动脉CTA联合扫描患者的临床数据。这些患者被分为心律不齐组和正常心律组。对2组患者的扫描时间、客观图像质量[CT值、对比度噪声比(CNR)等]、主观图像质量评分和辐射剂量进行评估。结果:67名患者(平均年龄63岁,49名男性)被纳入此次研究。心律不齐和正常心律患者的心脏和头颈段的CNR没有统计学差异(心脏:10.59±2.64 vs10.83±2.67,P=0.33;头颈:36.19±16.54vs37.06±20.12,P=0.61)。心律不齐组和正常心律组在主观图像质量评分上的差异没有统计学意义(心脏:3.33±0.57vs3.41±0.55,P>0.05;头颈:3.93±0.26vs3.92±0.26,P>0.05)。心律不齐组的心脏段扫描时间和辐射剂量多于正常心律组,且存在统计学差异[扫描时间:(0.69±0.2)svs(0.58±0.14)s,P=0.01;有效辐射剂量:(4.66±1.21)mSv vs(4.01±0.75)mSv,P=0.03]。2组患者的头颈段扫描时间和辐射剂量无统计学差异(P>0.05)。结论:心律不齐患者在进行冠状动脉和头颈动脉CTA联合扫描时,采用320排宽体探测器CT扫描仪,能够获得与正常心律患者相媲美的图像质量。

Purpose:To explore the image quality and radiation dose of combined coronary and craniocervical computed tomography angiography(CTA)in patients with arrhythmia.Methods:Retrospective enrollment included patients underwent combined coronary and craniocervical CTA from January 2022 to December 2022.Patients were divided into two groups:group 1 consisted of patients with arrhythmia,and group 2 consisted of patients with normal rhythm.Scan time,objective image quality[CT value,contrast to noise ratio(CNR),etc.],subjective image quality,and radiation dose were evaluated for both groups.Results:A total of 67 patients(mean age 63 years,49 males)were included.There was no statistically significant difference in CNR between patients with arrhythmia and those with normal rhythm in the cardiac and craniocervical segments(cardiac:10.59±2.64 vs 10.83±2.67,P=0.33;craniocervical:36.19±16.54 vs 37.06±20.12,P=0.61).Subjective image evaluation revealed that there were no statistically significant differences in subjective image scores between arrhythmia group and normal rhythm group(cardiac:3.33±0.57 vs 3.41±0.55,P>0.05;craniocervical:3.93±0.26 vs 3.92±0.26,P>0.05).The scan time and radiation dose of cardiac segment were higher in the arrhythmia group than those in the normal rhythm group,and the differences were with statistical significance[scan time:(0.690.2)s vs(0.58±0.14)s,P-0.01;effective radiation dose:(4.66±1.21)mSv vs(4.01±0.75)mSv,P=0.03].There were no significant differences in scan time and radiation dose between the two groups in the craniocervical segment(P>0.05).Conclusion:Patients with arrhythmia performed combined coronary and craniocervical CTA using 320-row wide-detector CT scanner could achieve comparable image quality to patients with normal rhythm.