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双源计算机断层摄影回顾性心电门控胸腹联合主动脉血管造影图像质量
Aortic and Coronary Assessment in Retrospectively Electrocardiogramgated Thoracal-abdominal Dual-source Computed Tomographic Angiography of Aorta
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摘要:目的 评价双源计算机断层摄影(computed tomography, CT)回顾性心电门控胸腹联合主动脉血管造影对主动脉和冠状动脉的显示及放射剂量。方法 回顾性分析2009年12月至2010年11月本院行主动脉计算机断层摄影血管造影(computed tomography angiography, CTA)患者45例, 其中回顾性心电门控胸部联合腹部扫描患者23例, 常规无心电门控主动脉CTA扫描患者22例, 比较两种不同扫描方式主动脉根部、主动脉弓、腹主动脉起始部、主动脉分叉部位的主动脉强化CT值, 比较两种不同扫描方式升主动脉部位图像噪音。采用3分制评分方法, 对主动脉根部及冠状动脉主要分支的图像质量进行评价, 比较两种不同扫描方式主动脉根部及冠状动脉图像质量; 并比较两种不同扫描方式的有效放射剂量。结果 回顾性比较心电门控胸部联合腹部及常规无心电门控血管造影主动脉4个不同部位的CT值差异无显著意义, 主动脉根部分别为(280.8±63.4)和(329.3±43.2)HU, 主动脉弓分别为(288.9±60.9)和(320.7±47.6)HU, 腹主动脉起始部分别为(267.2±65.1)和(315.4±43.5)HU, 主动脉分叉分别为(293.3±75.2)和(322.7±45.8)HU, 均P > 0.05;常规无心电门控主动脉CTA扫描图像噪音(11.8±2.5)HU小于回顾性心电门控胸部联合腹部扫描的(19.3±4.8)HU, P=0.002。采用回顾性心电门控胸部联合腹部扫描, 主动脉根部及冠状动脉主要分支有较高的可评价率, 主动脉根部100%(23/23), 冠状动脉83%(19/23);明显高于常规无心电门控主动脉CTA扫描, 主动脉根部5%(1/22), 冠状动脉0%(0/22), P < 0.001。回顾性心电门控胸部联合腹部扫描的有效射线剂量明显高于常规无心电门控主动脉CTA扫描(P=0.038)。结论 采用回顾性心电门控胸部联合腹部主动脉CTA扫描, 可以使全主动脉得到良好的强化, 能够清晰显示主动脉根部, 并可评价冠状动脉, 有效射线剂量高于无心电门控主动脉CTA。Abstract:Objective To evaluate image quality of aortic and coronary arteries and radiation dose in retrospective electrocardiography (ECG) -gated thoracal-abdominal dual-source computed tomographic angiography (CTA) of aorta.Methods Totally 45 patients who underwent aorta CTA from December 2009 to Novem-ber 2010 were evaluated retrospectively. Among them 23 patients underwent retrospective ECG-gated thoracalabdominal dual-source CTA of aorta, while 22 underwent conventional non-ECG-gated aortic CTA. The attenuation and image noise of 4 parts of aorta (aortic root, aortic arch, abdominal aorta, and aortic bifurcation) were evaluated. Image quality of aortic root and coronary arteries were assessed using a 3-point scale. Attenuation, image noise, image quality, and radiation dose were compared between two groups who underwent different scan protocols.Results Attenuation of 4 different parts of aorta showed no significant difference between two groups (P > 0.05). Image noise was significantly lower in conventional non-ECG-gated group than in retrospective ECG-gated group (P=0.002). The percentage of patients with diagnostic image quality was high in retrospective ECG-gated group:aortic root, 100% (23/23); coronary artery, 83% (19/23), which was significantly higher than in conventional non-ECG-gated group; aortic root, 5% (1/22); coronary artery, 0% (0/22) (P < 0.001). The effective radiation dose was significantly higher in retrospective ECG-gated group than in conventional non-ECG-gated group (P=0.038).Conclusions Retrospective ECG-gated thoracal-abdominal dual source CTA of aorta provides well attenuated whole aorta, well displayed aortic root, and assessable coronary arteries. However, the effective radiation dose used in this mode is higher than that in conventional nonECG-gated aortic CTA.
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