Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography corona...Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography coronary angiography (CTCA) in patients with relatively higher heart rates (HR) compared with catheter coronary angiography (CCA). Methods Forty-seven consecutive patients with relatively higher HR (>65 and <100 bpm) (20 male, 27 female; age 55±10 years) who both underwent dual-source CTCA and CCA were prospectively included in this study. All patients were performed CTCA using high pitch mode setting at 20%-30% of the R-R interval for the image acquisition. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a three-point scale (1: excellent to 3: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). Considered CCA as the standard of reference, the sensitivity, specificity, positive predictive value and negative predictive value were calculated. Radiation dose values were calculated using the dose-length product. Results Image quality was rated as being score 1 in 92.4% of segments, score 2 in 6.1% of segmentsand score 3 in 1.5% of segments. The average image quality score per segment was 1.064±0.306. The HR variability of patients with image score 1, 2 and 3 were 2.29±1.06 bpm, 5.17±1.37 bpm, 8.88±1.53 bpm, respectively. The average HR variability of patients with different image scores were significantly different (F=170.402, P=0.001). The sensitivity, specificity, positive and negative predictive values were 92.6%, 97.0%, 87.6%, 98.3%, respectively, per segment and 90.0%, 95.2%, 85.3%, 96.9%, respectively, per vessel and 100%, 63.6%, 90.0%, 100%, respectively, per patient. The effective radiation dose was on average 0.86±0.16 mSv. Conclusion In patients with HR more than 65 bpm and below 100 bpm without cardiac arrhythmia, the prospectively electrocardiogram-gated high-pitch spiral acquisition mode with image acquired timing set at 20%-30% of the R-R interval provides a high diagnostic accuracy for the assessment of coronary stenoses combined with a 1.5% of non-diagnostic coronary segments and a radiation dose below 1 mSv.展开更多
要为明确高密度互通立交行驶环境下,主线车流量对出入口区段驾驶人精神负荷间的影响,在重庆市内环快速路高密度互通立交群进行自然驾驶实车试验,使用Physiolab生理检测仪连续采集驾驶人在行驶过程中的心电数据,用于统计各驾驶人的心率...要为明确高密度互通立交行驶环境下,主线车流量对出入口区段驾驶人精神负荷间的影响,在重庆市内环快速路高密度互通立交群进行自然驾驶实车试验,使用Physiolab生理检测仪连续采集驾驶人在行驶过程中的心电数据,用于统计各驾驶人的心率指标变化情况。本次试验基于主成分分析法选择心率变异率指标RMSSD(root mean square of successive differences)、LFnorm(low frequency norm)、HFnorm(high frequency norm)、LF(low frequency)/HF(high frequency)以及心率突变率指标HRMR(heat ratemutation rate)作为驾驶人精神负荷的评价指标,记为主成分F 1和主成分F 2,并建立评价模型。结果表明:驾驶人在小净距立交出入口区段行驶时,立交主线车流量的大小会影响驾驶人的精神负荷;当驾驶人驶入立交主线时,三次模型对入口段车流量与主成分F 2的拟合效果最好,呈开口向上的三次曲线,曲线谷值点出现在2级流量水平处,模型显著;当驾驶人驶出立交主线时,一次线性模型对出口段车流量与主成分F 1的拟合效果最好,模型显著。展开更多
基金Supported by the Ministry of Science and Technology of Inner Mongolia, China (20110504)
文摘Objective To prospectively investigate the diagnostic accuracy for coronary artery stenosis of prospectively electrocardiogram-triggered spiral acquisition mode (high pitch mode) dual-source computed tomography coronary angiography (CTCA) in patients with relatively higher heart rates (HR) compared with catheter coronary angiography (CCA). Methods Forty-seven consecutive patients with relatively higher HR (>65 and <100 bpm) (20 male, 27 female; age 55±10 years) who both underwent dual-source CTCA and CCA were prospectively included in this study. All patients were performed CTCA using high pitch mode setting at 20%-30% of the R-R interval for the image acquisition. All coronary segments were evaluated by two blinded and independent observers with regard to image quality on a three-point scale (1: excellent to 3: non-diagnostic) and for the presence of significant coronary stenoses (defined as diameter narrowing exceeding 50%). Considered CCA as the standard of reference, the sensitivity, specificity, positive predictive value and negative predictive value were calculated. Radiation dose values were calculated using the dose-length product. Results Image quality was rated as being score 1 in 92.4% of segments, score 2 in 6.1% of segmentsand score 3 in 1.5% of segments. The average image quality score per segment was 1.064±0.306. The HR variability of patients with image score 1, 2 and 3 were 2.29±1.06 bpm, 5.17±1.37 bpm, 8.88±1.53 bpm, respectively. The average HR variability of patients with different image scores were significantly different (F=170.402, P=0.001). The sensitivity, specificity, positive and negative predictive values were 92.6%, 97.0%, 87.6%, 98.3%, respectively, per segment and 90.0%, 95.2%, 85.3%, 96.9%, respectively, per vessel and 100%, 63.6%, 90.0%, 100%, respectively, per patient. The effective radiation dose was on average 0.86±0.16 mSv. Conclusion In patients with HR more than 65 bpm and below 100 bpm without cardiac arrhythmia, the prospectively electrocardiogram-gated high-pitch spiral acquisition mode with image acquired timing set at 20%-30% of the R-R interval provides a high diagnostic accuracy for the assessment of coronary stenoses combined with a 1.5% of non-diagnostic coronary segments and a radiation dose below 1 mSv.
文摘要为明确高密度互通立交行驶环境下,主线车流量对出入口区段驾驶人精神负荷间的影响,在重庆市内环快速路高密度互通立交群进行自然驾驶实车试验,使用Physiolab生理检测仪连续采集驾驶人在行驶过程中的心电数据,用于统计各驾驶人的心率指标变化情况。本次试验基于主成分分析法选择心率变异率指标RMSSD(root mean square of successive differences)、LFnorm(low frequency norm)、HFnorm(high frequency norm)、LF(low frequency)/HF(high frequency)以及心率突变率指标HRMR(heat ratemutation rate)作为驾驶人精神负荷的评价指标,记为主成分F 1和主成分F 2,并建立评价模型。结果表明:驾驶人在小净距立交出入口区段行驶时,立交主线车流量的大小会影响驾驶人的精神负荷;当驾驶人驶入立交主线时,三次模型对入口段车流量与主成分F 2的拟合效果最好,呈开口向上的三次曲线,曲线谷值点出现在2级流量水平处,模型显著;当驾驶人驶出立交主线时,一次线性模型对出口段车流量与主成分F 1的拟合效果最好,模型显著。