双源CT适应性序列扫描技术在低剂量冠状动脉成像中的应用价值
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The application of dual-source CT of adaptive sequence scannings technique in the low-dose computer tomography coronary angiographyrtery
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    摘要:

    目的:探讨双源CT(dual-source CT,DSCT)适应性序列扫描技术在低剂量冠状动脉成像(CTCA)中的应用价值-方法:285例疑诊冠心病患者,将心率> 70次/min且心律规整者随机分成实验组(145例)和对照组(140例),实验组行前瞻性门控适应性序列扫描,对照组行常规回顾性心电门控螺旋扫描,实验组和对照组中分别有33例-32例2周内行常规冠状动脉造影(CCA)-用-字2检验比较两组CTCA对冠状动脉的可评价率,用两独立样本t检验比较两组患者冠脉图像质量评分及患者接受的有效辐射剂量,用Kappa检验评价两组CTCA与CCA检查对冠状动脉狭窄度评估的一致性,应用两独立样本t检验比较两组患者有效辐射剂量-结果:实验组和对照组参与评价的冠状动脉节段可评价率分别为98.4%(1 787/1 816)-98.1%(1 717/1 750),差异无统计学意义(-字2 = 0.14,P = 0.706);两组图像质量评分分别为(4.42 ± 0.64)分-(4.41 ± 0.65)分,差异无统计学意义(t = 0.38,P = 0.710);两组CTCA与CCA诊断冠状动脉狭窄度的一致性检验结果分别是Kappa = 0.829和0.845,两组对诊断冠状动脉狭窄度的一致性均具有统计学意义;实验组和对照组患者接受的有效辐射剂量分别是(4.60 ± 0.98)和(12.60 ± 1.90)mSv,两组间差异有统计学意义(t = 44.8,P = 0.000)-结论:心率> 70次/min且心律规整者采用适应性序列扫描,既能保证诊断所需的图像质量,对冠状动脉狭窄度具有较高的诊断正确性,又能显著降低辐射剂量-

    Abstract:

    Objective:To evaluate the application of adaptive sequence scanning techniqueology dual-source CT(DSCT) in the low-dose computer tomography coronary angiography (CTCA). Methods:Two hundred and eight-five patients suspected of coronary artery disease with heart rate > 70 bpm and regular rhythm were randomly assigned into experimental study group (145 cases) and control group(140 cases). Study group were checked with adaptive sequence scanning technique,and control group with retrospective ECG-gated spiral scanning. There were 33 cases in study group and 32 cases in control group undergoing conventional coronary angiography(CCA) within 2 weeks. The coronary artery evaluation rate of CTCA between two groups were compared using -字2 test. The imaging quality of coronary artery and radiation dose of two groups were compared using t test,the consistency of coronary artery stenosis in CTCA and in CCA were evaluated with the Kappa test. Results:The evaluation rate of coronary artery in the study and control group were 98.4%(1 787/1 816) and 98.1%(1 717/1 750),respectively. The image quality scores of two groups were(4.42 ± 0.64) and(4.41 ± 0.65) respectively,and there was no statistical difference in scores of imaging quality between the two groups (t = 0.38,P = 0.710). The consistency of CTCA and CCA in diagnosing coronary artery stenosis of two groups were 0.829 and 0.845 by Kappa test,respectively. The average effective radiation doses of study group and control group were (4.60 ± 0.98) and (12.60 ± 1.90) mSv,and there were significant differences between two groups (t = 44.89,P = 0.000). Conclusion:Using DSCT adaptive sequence scanning technique in CT coronary angiography to check the patients with heart rate > 70 bpm and regular rhythm can ensure good image quality and high diagnostic accuracy of coronary artery stenosis,and also significantly reduce the radiation dose.

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钱萍艳,方向明,陈宏伟,丁国良,胡钢峰,陈 寅,王 凯.双源CT适应性序列扫描技术在低剂量冠状动脉成像中的应用价值[J].南京医科大学学报(自然科学版),2012,(8):1144-1148

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  • 收稿日期:2011-12-19
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