摘要
目的比较前瞻性和回顾性心电门控扫描模式在双源CT评估冠状动脉支架成像中的图像质量、诊断准确性及放射线剂量中的价值。方法将60例冠状动脉支架术后患者分为两组,分别行前瞻性与回顾性心电门控冠状动脉CT扫描。以冠状动脉造影作为参考标准,分别对支架的图像质量进行评估。结果两组患者临床资料匹配性、图像质量的评价一致性良好,差异无统计学意义。患者的图像质量与年龄、体重指数和心率均无相关性,在前瞻性心电门控扫描组心率波动对图像质量有较弱影响。前瞻性门控组中,敏感度、特异度、阳性预测值、阴性预测值分别为100%、84.09%、68.18%和100%;回顾性门控组为94.44%、86.84%、77.27%和97.06%。两组放射剂量有明显差异。用平滑重建算法的图像噪声差异有统计学意义,锐利算法差异无统计学意义。结论对于心律齐且心率≤70次/分的患者,回顾性心电门控扫描方法与前瞻性心电门控扫描方式评估冠状动脉支架效果相似,但前者的有效放射剂量明显减少。
Objective To compare image quality, diagnostic accuracy and radiation dose of prospective and retrospective electrocardiogram （ECG） gating dual source computed tomography （DSCT） in evaluation of coronary stent. Methods Sixty patients with previous conventional coronary angiography （CA） and stent implantation were divided in two groups, then prospective or retrospective ECG-gated DSCT were performed, and the image quality of CT angiography （CTA） were evaluated with those of CA in each group. Results Image quality was not influenced by age, body mass index （BMI） or heart rate in each group, but heart rate variability had a weak impact on the prospective group. Image noise was higher in the prospective group, but only reached statistical significance using smooth kernel reconstruction. The sensitivity, specificity, positive and negative predictive value of CTA was 100%, 84.09%, 68.18% and 100% respectively in the prospective group, while was 94.44%, 86.84%, 77.27 % and 97.06 % respectively in the retrospective group. There was significant difference in the radiation dose between the two groups. Conclusion Compared with retrospective CTA, prospective CTA has similar per formance in assessing coronary stent, but lower effective dose in patients with regular heart rhythm and heart rates ≤70 beat per minute.
出处
《中国医学影像技术》
CSCD
北大核心
2009年第8期1504-1507,共4页
Chinese Journal of Medical Imaging Technology
