[1]杨晓波,杨俊杰,田峰,等.双源CT大螺距前瞻性双次扫描模式在冠心病诊断中的价值[J].南方医科大学学报,2013,(11):1605.
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双源CT大螺距前瞻性双次扫描模式在冠心病诊断中的价值()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2013年11期
页码:
1605
栏目:
出版日期:
2013-11-15

文章信息/Info

Title:
High-pitch dual-source CT in prospectively electrocardiogram-triggered spiral double scanning mode for diagnosing coronary artery patency
作者:
杨晓波杨俊杰田峰周迎汪奇张华巍杜洛山陈韵岱
关键词:
冠状动脉狭窄体层摄影术X线计算机冠状动脉造影术
Keywords:
coronary artery stenosis coronary angiography tomography X-ray computed
摘要:
目的评价双源CT大螺距前瞻性心电门控双次扫描模式(Double Flash)显示冠状动脉的图像质量、诊断冠状动脉狭窄的
准确性及辐射剂量。方法入选采用Double Flash 模式CT冠状动脉成像(CTCA)和冠状动脉造影(CAG)检查的患者,根据检
查时心率不同,将患者分为A组(心率<65次/min)和B组(65次/min≤心率<80次/min),评价两组冠状动脉各段图像质量(1~4
分);以CAG结果为金标准,分别基于患者和血管评价该扫描模式诊断冠状动脉狭窄的敏感度、特异度、阳性预测值、阴性预测
值和准确度;并评价患者辐射剂量。结果114例患者共显示冠状动脉1725个节段(A组933段、B组792段):(1)图像质量:A组
采用Double Flash模式两次扫描综合显示可诊断的血管节段百分比为98.5%,而B组为97.3%,差异无统计学意义(P=0.82);两
组血管的图像质量总体评分差异无统计学意义(P>0.05);(2)准确性评价:基于患者水平分析,A组Double Flash模式两次扫描
综合显示有意义的冠状动脉狭窄的敏感度、特异度、阳性预测值、阴性预测值和准确度分别为100%、90.5%、95.4%、100%和
96.7%,而B组为100%、88.5%、94.5%、100%和96.2%,两组比较无统计学差异(P>0.05);(3)辐射剂量:平均有效辐射剂量为
1.63±0.52 msv。结论双源CT Double Flash模式具有临床可行性,尤其对于65次/min≤心率<80次/min的患者,在较低的辐射
剂量条件下,可保证较好的图像质量和诊断冠状动脉狭窄准确性。
Abstract:
Objective To assess the image quality, diagnostic accuracy and effective radiation dose of prospectively ECGtriggered
high-pitch spiral double scanning (Double Flash) mode of computed tomography coronary angiography (CTCA)
using dual-source CT for the diagnosis of significant coronary stenoses. Methods Patients underwent both CTCA in Double
Flash mode and conventional coronary angiography (CAG) and were divided into two groups according to heart rate (HR),
namely group A with HR <65/min (62 cases) and group B with HR between 65 and 80/min (52 cases). All the coronary
segments were evaluated by two blinded and independent observers for image quality on a four-point scale and for the
presence of significant coronary stenoses (defined as a diameter narrowing exceeding 50%). CAG served as the reference
standard for analyzing the diagnostic accuracy of Double Flash mode images on the level of both patients and vessels.
Radiation dose values were calculated using the dose-length product. Results A total of 114 patients were enrolled and 1725
vessel segments were displayed. In terms of image quality, the diagnosable segments accounted for 98.5% (919/933) in group A
and 97.3% (770/792) in group B. In the per-patient analysis, the diagnostic sensitivity, specificity, positive predictive value,
negative predictive value and accuracy were 100%, 90.5%, 88.2%, 100% and 96.7% in group A and were 100%, 88.5%, 94.5%,
100% and 96.2% in group B, respectively. The mean effective radiation dose was 1.63±0.52 mSv. Conclusion Double Flash spiral
protocol of dual-source CTCA can acquire good image quality and yield high diagnostic accuracy for assessment of coronary
artery stenoses at a low radiation dose in patients with HR between 65 and 80/min.

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更新日期/Last Update: 1900-01-01