心电编辑技术在64层螺旋CT冠状动脉成像中的临床应用分析

64-detector row CT coronary angiography:clinical application of retrospective electrocardiographic gating technique combined with electrocardiographic editing

目的探讨心电编辑技术在64层螺旋CT冠状动脉成像检查中心电信号异常患者中的应用价值。方法病例选取我院行64层螺旋CT经静脉冠状动脉造影,且心率不齐,常规重组伪影严重,影响影像诊断的患者共36例。对常规CT重组影像和心电编辑后重组影像质量进行比较,根据节段显示情况及是否存在伪影将图像质量分为I~Ⅳ级,I~Ⅲ级符合影像学评价要求,I~Ⅱ级为优良阶段。比较64层螺旋CT回顾性心电门控结合心电编辑技术对心电获得异常患者的冠状动脉影像质量的影响。结果 36例患者心电编辑前后可显示冠脉总数分别为521段和528段,心电编辑前图像质量Ⅰ、Ⅱ、Ⅲ、Ⅳ级节段分别为133段(25.5%)、162段(31.1%)、120段(23.0%)、106段(20.3%),图像质量符合诊断要求的共415段(79.6%)。心电编辑后图像质量Ⅰ、Ⅱ、Ⅲ、Ⅳ级节段分别为439段(83.1%)、70段(13.3%)、8段(1.5%)、11段(2.1%),冠状动脉显影优良节段为509段(96.4%),符合诊断要求节段共517段(97.9%),冠状动脉各段在心电编辑前后的影像质量差异均有统计学意义(P<0.05)。结论心电信号编辑能明显改善部分期前收缩和心电信号中出现触发点异常患者的冠状动脉MSCTA图像质量,具有一定的临床实用价值。

Objective To prospectively evaluate to what extent image quality in 64-detector row computed tomographic(CT)coronary angiography is a function of electrocardiographic editing and the image reconstruction technique used.Methods A total of 36patients(14men,22women;mean age,61.0years±9.1)in department of radiology consecutively underwent multi-detector row CT coronary angiography.Their electrocardiographic trigger points were proved to be inaccurately or absent,which caused unequal R-R intervals.Image reconstruction was based on both before and after electrocardiographic trigger points editing.Reconstructed images were classified by artifacts as grades I~Ⅳ,in which grades I~Ⅲ were considered to have diagnostic value.Results Among the total of 36 patients,there were 521 and 528segments of coronary arteries before and after electrocardiographic editing,respectively.Before electrocardiographic editing,images quality of gradesⅠ,Ⅱ,Ⅲ,Ⅳ were 133(25.5%),162(31.1%),120(23.0%),106(20.3%),respectively.It was415(79.6%)segments that with diagnostic value.After electrocardiographic editing,images quality of grades Ⅰ,Ⅱ,Ⅲ,Ⅳ were 439(83.1%),70(13.3%),8(1.5%),11(2.1%),respectively.It was 517(97.9%)segments that with diagnostic value.There was significant difference between before and after electrocardiographic trigger points editing(P<0.05).Conclusion In multi-detector row CT coronary angiography,when inaccurately or absent electrocardiographic trigger points were found,image quality could be improved by retrospective electrocardiographic gating technique combined with electrocardiographic editing techniques.