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目的:通过低心率下宽采集窗与窄采集窗图像质量与辐射剂量对比,明确窄采集窗320排CT冠脉造影的临床应用价值。方法:前瞻性选取2015年9月至2016年1月拟行CTCA且心率(HR)≤65次/min、心率变异度(HRv)≤5次/min的患者80例,平均年龄51岁(范围:36岁~83岁)。所选患者随机分为A、B两组,其中A组(n=40)采集期相设置为R-R间期70%~80%。B组(n=40)采集期相设置为R-R间期30%~80%。两组设置管电压100 k V,依据体质量指数自动设置管电流300~580 m A。评价并比较A、B两组辐射剂量与图像质量。结果:A、B两组辐射剂量差异具有统计学意义(2.02 m Sv±0.78 m Sv vs 4.35 m Sv±0.85 m Sv,t=-12.474,P=0.000)。A和B两组可评估率差异无统计学意义(χ2=0.215,P=0.643)。A组平均评分3.61±0.53,B组平均评分3.71±0.48,Z=-3.074,P=0.002,差异有统计学意义。A、B两组主动脉根部衰减值差异无统计学意义(t=-1.132,P=0.261)。结论:320排螺旋CT窄采集窗设置可以提供可评估的图像质量,从而大幅度减少辐射剂量。
OBJECTIVE: To determine the clinical value of 320-slice CT coronary angiography using a narrow acquisition window by comparing the image quality of wide acquisition window with that of narrow acquisition window under low heart rate. Methods: A total of 80 patients with a mean heart rate (HR) ≦ 65 beats / min and heart rate variability (HRv) ≤ 5 beats / min were selected prospectively from September 2015 to January 2016. The mean age was 51 years (range : 36 years old to 83 years old). Selected patients were randomly divided into A, B two groups, of which A group (n = 40) acquisition phase set R-R interval of 70% to 80%. Group B (n = 40) acquisition phase set R-R interval of 30% to 80%. The two sets of tube voltage 100 k V, according to the body mass index automatically set the tube current 300 ~ 580 m A. Evaluate and compare the radiation dose and image quality of A and B groups. Results: There was a significant difference in radiation dose between groups A and B (2.02 m Sv ± 0.78 m Sv vs. 4.35 m Sv ± 0.85 m Sv, t = -12.474, P = 0.000). There was no significant difference in assessable rates between groups A and B (χ2 = 0.215, P = 0.643). The average score of group A was 3.61 ± 0.53, the average score of group B was 3.71 ± 0.48, Z = -3.074, P = 0.002, the difference was statistically significant. There was no significant difference in attenuation value of aortic root between groups A and B (t = -1.132, P = 0.261). Conclusion: The 320-slice spiral CT narrow acquisition window settings provide a measurable image quality, resulting in a significant reduction in radiation dose.