血管内超声显像在冠心病支架植入术中的应用

目的探讨血管内超声在冠心病支架植入中的作用。方法50例患者的52处病变在支架植入前后分别用血管内超声进行定量和定性分析,并根据血管内超声标准决定支架的直径以及植入的终点,分析CAG和IVUS对支架植入终点判断的差异和最终获得的管腔面积大小的差别以及支架后管腔面积增大的机制。结果IVUS比CAG判断的平均支架直径大[(3.48±0.29)mmvs(3.36±0.33)mm,P=0.011],支架囊的最终峰值压力明显增大[(17.7±2.9)atmvs(12.8±2.4)atm,P<0.001],QCA测得的支架面积狭窄百分比减小(13.2%±6.6%vs16.6%±9.1%,P=0.044);首次高压扩张后支架满意率CAG达96.2%,而IVUS只有37.7%。IVUS指导后最终的球囊压力更高[(16.13±1.87)atmvs(12.62±2.61)atm,P<0.001],获得的管腔直径更大[(3.64±0.53)mmvs(3.31±0.57)mm,P<0.001],管腔面积也更大[(9.90±2.05)mm2vs(8.84±1.67)mm2,P<0.001],面积狭窄百分比更小(49.15%±9.03%vs54.24%±10.05%,P<0.001];所有患者支架的近段和远段CAG均未发现明显的狭窄。而IVUS却发现支架近段血管有39例(75.0%),远段血管有23(44.2%)例存在动脉粥样硬化斑块;支架植入后非脂质斑块较脂质斑块获得的管腔面积更大[(4.50±1.67)mm2vs(3.68±0.97)mm2,P<0.001],其中脂质斑块血管面积增大较非脂质斑块小1.30mm2,斑块压缩程度却增加0.48mm2。结论IVUS较CAG能更好地判断病变的性质,指导支架更好地选择,可获得更大的管腔面积,更小的面积狭窄百分比。     

中等程度冠状动脉狭窄的血管内超声特点与治疗决策选择

目的　应用血管内超声 (IVUS)观察冠状动脉造影中等程度冠状动脉狭窄的血管内超声特点 ,选择治疗决策。方法　应用血管内超声仪检查 3 8例血管造影狭窄程度 40 %～ 60 %患者的 43处冠状动脉病变 ;测量管腔以及血管直径和面积。结果　 43处病变中 ,脂质斑块为 3 0处 ,纤维、钙化、混合斑块分别为 4、2、5处 ,2处未发现明显病变或仅轻度内膜增生 ;其中 4处可见明显血栓影。 41处粥样硬化斑块中偏心斑块 3 6处 ( 87.8% ) ,向心斑块 5处 ( 12 .2 % )。 3 0处脂质斑块大部分可见薄的纤维帽 ,其中 5处 ( 16.7% )明显的纤维帽不完整。病变血管直径狭窄百分比 ( 4 0 .73± 13 .2 1) % ;面积狭窄百分比 ( 5 6.75± 12 .68) %。对IVUS示面积狭窄 >5 0 %的 2 5处、<5 0 %的 1处 ( 60 .5 % )且有典型临床症状的病变行进一步介入治疗 ,对IVUS示面积狭窄 <5 0 %的 17处 ( 3 9.5 % )病变未行进一步介入治疗。结论　IVUS可进一步明确血管造影中等程度冠状动脉病变的性质、严重性和稳定性 ,指导进一步的治疗     

MSCT检测冠心病患者心外膜脂肪组织容积与左心室舒张功能的相关性

目的观察冠心病(CAD)患者心外膜脂肪组织(EAT)容积与左心室舒张功能的相关性。方法纳入55例接受冠状动脉CTA的CAD患者,将冠状动脉CTA薄层图像导入GE AW 4.4工作站,手动勾画心包线,测量EAT容积;采用彩色多普勒超声测量舒张早期、舒张晚期经二尖瓣血流峰值流速(E、A)以及舒张早期二尖瓣隔部组织运动峰值速度(Ea),计算E/A和E/Ea值。分析EAT容积与E/A和E/Ea的相关性。结果 CAD患者EAT容积与E/A呈负相关(r=-0.376,P=0.005),与E/Ea呈正相关(r=0.368,P=0.006)相关;校正CAD危险因子后,EAT容积是E/Ea的独立影响因子(b=0.011,t=2.12,P=0.04)。结论 CAD患者EAT容积与左心室舒张功能相关性较好;MDCT定量测量EAT容积对评价左心室舒张功能异常具有重要意义。     

超声测量心外膜脂肪厚度联合二维纵向应变预测冠状动脉粥样硬化性心脏病

目的探讨常规超声心动图测量的心外膜脂肪(EAT)厚度联合二维纵向应变对冠状动脉粥样硬化性心脏病(CAD)的预测价值。方法将106例疑诊为CAD的患者根据CAG检查结果分为CAD组(n=60)和对照组(n=46),采用二维超声测量收缩末期EAT厚度(EAT_S)、舒张末期EAT厚度(EAT_D),采用二维应变软件分析左心室心尖三个切面的图像,获取左心室17节段心肌纵向应变均值(GLS_(17))和12节段(除外5个心尖节段)纵向应变均值(GLS_(12))。绘制ROC曲线,根据最大Youden指数确定EAT_S、GLS_(12)最佳预测截断值,分析EAT_S、GLS_(12)及二者联合诊断CAD的曲线下面积(AUC),并比较3种方法对CAD的预测价值。结果CAD组EAT_S、EAT_D均大于对照组(P均0.05);EAT_S(OR=1.79)、GLS_(12)(OR=1.20)均为CAD的独立危险因素(P均0.05),其对CAD的最佳预测截断值分别为5.55mm、-16.95。EAT_S、GLS_(12)及二者联合预测CAD的AUC分别为0.67±0.05、0.64±0.06及0.71±0.05,差异有统计学意义(P0.05)。结论 EAT_S与GLS_(12)均可以作CAD预测评估的有效指标,二者联合对CAD的预测价值更高。     

下肢动脉超声在2型糖尿病合并冠心病中的应用

目的:探讨下肢动脉超声在糖尿病(DM)合并冠心病(CAD)中的应用价值.方法:对因心律失常、胸痛等症状入院经冠状动脉造影(CAG)已确诊的CAD患者136例,其中60例合并2型糖尿病为糖尿病组(A组),76例未合并糖尿病患者为非糖尿病组(B组),采用高频超声观察下肢动脉情况(其中包括血管内径ID、内中膜厚度IMT、有无斑块形成)并与CAG结果对照.结果:与非糖尿病组患者相比,糖尿病组患者较非糖尿病患者下肢动脉粥样硬化、斑块检出率明显增高(p＜0.05),糖尿病组患者其冠状动脉狭窄程度严重,多为多血管病变.结论:下肢动脉硬化超声对DM合并CAG病变程度的预测有重要意义,可以作为诊断DM合并CAG的一项重要辅助检查.     

肺超声评分鉴别急性胰腺炎病情危重程度及预后评估

目的观察肺超声评分(LUS)鉴别急性胰腺炎(AP)病情危重程度及预后评估。方法前瞻性纳入2021年8月至2023年4月郑州大学第二附属医院重症医学科54例AP患者, 根据严重程度将其分为中度急性胰腺炎(MAP)组和重症急性胰腺炎(SAP)组。根据SAP组出院时预后情况将患者分为预后良好组与预后不良组, 于入院24 h内行肺部超声检查及实验室检查, 观察各指标组间差异, 绘制受试者工作特征(ROC)曲线, 采用DeLong检验比较曲线下面积(AUC), 检验LUS对AP患者病情严重程度及预后的评估价值。结果 MAP组LUS低于SAP组[(10.23±2.29)分比(15.15±3.18)分, t=-7.414, P<0.05];MAP组APACHE Ⅱ评分低于SAP组[(5.80±1.63)分比(10.71±3.28)分, t=-7.183, P<0.05];MAP组PCT低于SAP组[(1.24±0.51) ng/ml比(15.35±13.98) ng/ml, t=-5.539, P<0.05];MAP组Lac低于SAP组[(1.10±0.59) mmol/L比(6....     

慢性稳定性心绞痛患者冠状动脉临界病变斑块性质的血管内超声分析

目的探讨慢性稳定性心绞痛患者冠状动脉临界病变血管内超声斑块影像学特征。方法对慢性稳定性心绞痛患者行冠状动脉造影检查,对冠状动脉造影显示为临界病变者,行血管内超声检查,评估斑块特征。结果 163例冠状动脉临界病变患者中薄帽纤维粥样硬化斑块(TCFA)、厚帽纤维粥样硬化斑块(ThCFA)患者分别为37、50例。TCFA、ThCFA患者临床特征、冠状动脉分布情况差异无统计学意义;超过50%的临界病变血管在左冠状动脉前降支;ThCFA患者平均斑块负荷、斑块面积高于TCFA患者;ThCFA及TCFA患者斑块成分以纤维组织最多,其次为纤维脂肪组织和坏死核心成分,高密度钙化面积最低。TCFA患者最小管腔面积≤4.0mm2者占18.92%(7/37),显著高于ThCFA患者。结论慢性稳定性心绞痛冠状动脉临界病变ThCFA患者斑块负荷更重,管腔面积更大。TCFA患者最小管腔面积≤4.0mm2比例更高。     

心肌桥患者桥前段冠状动脉狭窄程度及其校正的管腔内密度衰减梯度情况

目的分析完全和不完全心肌桥(MB)患者桥前段冠状动脉狭窄程度分布情况,并比较两类MB患者桥前段冠状动脉校正的管腔内密度衰减梯度(TAG-CCO)的差异。方法收集2018年3月至2020年3月保定市第一医院收治的83例MB患者的临床资料,使用冠状动脉计算机断层扫描血管造影(CCTA)检查,按照MB包绕情况分为完全组(n=31)和不完全组(n=52),比较不同MB类型桥前段冠状动脉狭窄程度,并计算桥前段冠状动脉在不同狭窄程度下的TAG-CCO值。结果两组患者的轻度狭窄、中度狭窄以及重度狭窄例数比较,差异均无统计学意义(P>0.05)。不完全组患者不同狭窄程度桥前段冠状动脉的TAG-CCO值均明显高于完全组患者,差异均有统计学意义(P<0.01);两组患者不同狭窄程度桥前段冠状动脉的TAG-CCO值组内比较,差异均有统计学意义(P<0.01)。两组患者桥前段冠状动脉的狭窄程度与TAG-CCO值均呈负相关(r=-0.887,P<0.05;r=-0.866,P<0.05)。结论完全和不完全MB患者CCTA检查桥前段冠状动脉TAG-CCO值在不同狭窄程度下差异显著,且桥前段冠状动脉TAG-CCO值与完全和不完全MB患者桥前段冠状动脉的狭窄程度均呈负相关。     

颈动脉狭窄同期行冠状动脉旁路移植术中改善脑血流的研究

目的 研究颈动脉狭窄患者在冠状动脉旁路移植术(CABG)术中通过单纯提高心肺转流流量对脑血流和预后改善的意义.方法 选取2006年1月至2008年3月,51例接受CABG的冠状动脉粥样硬化性心脏病合并颈动脉狭窄患者,将其分为A、B两组.A组患者15例(单侧或双侧颈动脉狭窄≥50%),其中男性14例,女性1例,年龄(68.5±7.7)岁;B组36例(双侧颈动脉狭窄均<50%),其中男性34例,女性2例,年龄(62.4±10.2)岁.针对A组患者适当提高转机流量,并通过术中颈动脉超声监测观察脑血流改善效果,结合术后神经功能评分评价保护作用.结果 心肺转流中控制A组转流量高于B组,A组为(3.18±0.23)L·m-2·min-1,B组为(2.80±0.29)L·m-2·min-1(P=0.001).心肺转流过程中A组平均动脉压为(67.0±9.1)mm Hg(1 mm Hg=0.133kPa),高于B组的(59.0±7.1)mm Hg(P=0.009).两组大脑中动脉血流无明显差异(P=0.159).出院前患者神经心理学评分无明显差异.结论 颈动脉狭窄患者行CABG时,通过适当提高心肺转流灌注流量,可以明显改善病变侧脑血流,预防术后发生因术中脑缺血导致的神经心理并发症.     

急性缺血性卒中患者颈动脉斑块超声观察

目的观察急性缺血性卒中患者的颈动脉斑块分布、管腔狭窄程度及不稳定斑块的危险因素。方法经头颅MRI证实的急性缺血性卒中患者909例为AIS组,选取同期非脑卒中住院患者885例为对照组,比较2组颈动脉斑块的分布及管腔狭窄程度。根据狭窄程度将AIS组分为狭窄率≥50%亚组及50%亚组,比较2亚组稳定性斑块与不稳定性斑块的检出率。比较AIS组不稳定斑块和非不稳定斑块患者的临床资料,以有统计学意义的指标为自变量,行多因素Logistic回归分析。结果 AIS组颈动脉多发斑块和不稳定斑块的检出率及管腔狭窄程度均显著高于对照组(P均0.001)。颈动脉狭窄率≥50%亚组的不稳定斑块检出率显著高于狭窄率50%亚组(P0.001)。单因素分析显示年龄、男性、糖尿病、血脂异常、吸烟及饮酒是AIS颈动脉不稳定斑块的危险因素(P均0.05);多因素分析显示年龄、糖尿病、血脂异常及吸烟是AIS颈动脉不稳定性斑块的独立危险因素(P均0.05)。结论颈动脉不稳定斑块、狭窄程度与AIS发生密切相关;年龄、糖尿病、血脂异常和吸烟是颈动脉不稳定斑块的独立危险因素。     

Screening and management for ischemic heart disease in patients undergoing emergency surgery for a type A acute aortic dissection

Purpose

We assessed the incidence of coronary artery disease (CAD) during hospitalization after emergency surgery for a type A acute aortic dissection.

Methods

A total of 123 patients underwent multi-slice computed tomography (MSCT) scans during an early stage after surgery. The patients were divided into two groups: group I consisted of 14 patients (11.4 %) who had coronary artery stenosis of more than 75 % on MSCT, and group II consisted of 109 patients (88.6 %) who had no coronary lesions.

Results

The prevalence of diabetes, dyslipidemia and a smoking history was significantly higher in group I. Although the serum low-density lipoprotein cholesterol levels were similar, the high-density lipoprotein cholesterol (HDL) level was significantly lower in group I (36.4 ± 7.9 mg/dl) than in group II (49.6 ± 13.5 mg/dl, P = 0.0005). The maximum carotid intima-media thickness (IMT) was significantly thicker in group I (1.17 ± 0.37 mm) compared to group II (0.96 ± 0.33 mm, P = 0.0297). The logistic regression analysis detected that a carotid IMT over 1.1 mm (odds ratio 4.35, P = 0.0371) and HDL less than 40 mg/dl (odds ratio 3.90, P = 0.0482) were predictors for CAD.

Conclusions

CAD screening should be recommended for patients with aortic dissection who have several atherosclerosis risk factors, even after emergency surgery.     

Weight loss following bariatric surgery decreases pericardial fat thickness lowering the risk of developing coronary artery disease

BackgroundPericardial fat has a local atherosclerotic effect and is associated with both metabolic syndrome (MetS) and coronary artery disease (CAD).ObjectivesThe aim of this study is to report changes in pericardial fat thickness (PFT) after bariatric surgery, and to investigate its significance on the risk of developing coronary artery disease (CAD).SettingAcademic institution.MethodsWe retrospectively measured the linear pericardial thickness from patients’ computed tomography (CT) scans within 5 years preoperatively and compared to any available CT scan within 5 years postoperatively. The PFT was measured at the right ventricular wall, perpendicular to the myocardium, at the level of the sternum. The risk of developing CAD was estimated by calculating the Framingham risk score (FRS). We divided the patients into 2 groups: laparoscopic sleeve gastrectomy (SG, Group 1), and laparoscopic gastric Roux-en-Y gastric bypass (LRYGB, Group 2). Common demographic characteristics and co-morbidities were collected along with the preoperative and postoperative lipid profiles.ResultsA total of 113 patients met the inclusion criteria, with 64 (56.6%) patients in group 1 and 49 (43.3%) patients in group 2. Group 1 consisted of 83.6% (n = 53) female patients versus 75.5% (n = 37) in group 2. The percent excess body mass index loss (%EBMIL) at 12 months was 74.4 ± 35.8% for group 1 versus 67 ± 30.1% for group 2 (P = .292). Pericardial thickness before surgery was 5.6 ± 1.9 mm and 4.6 ± 1.6 mm after surgery (P = .0001). The risk of CAD in females was 9.1% before and 6.6% after surgery. We found statistically significant linear association between pericardial thickness after surgery and a lower risk of CAD (P = .001).ConclusionBariatric surgery decreases the PFT lowering risk of developing CAD. Further studies may be needed to better assess these findings.     

基于CT定量心外膜脂肪组织与冠状动脉疾病的关系:Meta分析

目的 采用Meta分析评价CT定量心外膜脂肪组织（EAT）与冠状动脉疾病（CAD）的相关性。方法 检索中国知网、万方医学网、维普网及PubMed、Web of science、Medline数据库中自建库至2019年12月31日关于CT定量EAT与CAD相关性的病例对照研究,以Stata 12.0软件分析CAD组与非CAD组之间标准化均数差（SMD）及95% CI。结果 纳入19篇文献,CAD组5 129例,非CAD组7 434例;CAD组EAT厚度[SMD=0.46,95% CI（0.26,0.66）,P<0.01）]和容积[SMD=0.65,95% CI（0.46,0.86）,P<0.01）]均大于非CAD组。结论 CT定量EAT与CAD存在相关性。     

The effect of clinical coronary disease severity on outcomes of carotid endarterectomy with and without combined coronary bypass

ObjectiveThe management of patients with carotid stenosis and symptomatic coronary artery disease (CAD) is challenging. This study assessed the impact of clinical coronary disease severity on carotid endarterectomy (CEA) with and without combined coronary artery bypass (CCAB).MethodsUsing the Vascular Quality Initiative, patients with symptomatic CAD who underwent CCAB or isolated CEA (ICEA) from 2003 to 2017 were identified. Patients were stratified by CAD severity: stable angina (SA) and recent myocardial infarction/unstable angina (UA). Primary outcomes, including perioperative stroke, myocardial infarction (MI), and stroke/death/MI (SDM), were assessed between procedures within each CAD cohort.ResultsThere were 9098 patients identified: 887 CCAB patients (215 [24%] SA, 672 [76%] UA) and 8211 ICEA patients (6385 [78%] SA, 1826 [22%] UA). Overall, CCAB patients had higher rates of stroke (2.6% vs 1.3%; P = .002) and SDM (7.3% vs 3.5%, P < .001) but similar rates of MI (0.9% vs 1.6%; P = .12) compared with ICEA patients. In SA patients, no difference was seen in stroke (ICEA 1.2% vs CCAB 1.9%; P = .36), MI (1.3% vs 1.4%; P = .95), or SDM (2.9% vs 4.7%; P = .13). In UA patients, no difference was seen in stroke (ICEA 1.6% vs CCAB 2.8%; P = .06), but ICEA patients had higher rates of MI (2.4% vs 0.7%; P = .01) and CCAB patients had higher rates of SDM (8.2% vs 5.5%; P = .01). After logistic regression in the UA cohort, predictors of MI included ICEA (odds ratio [OR], 2.7; 95% confidence interval [CI], 1.1-7.0; P = .04) and carotid symptomatic status (OR, 2.1; 95% CI, 1.1-3.8; P = .01); carotid symptomatic status also predicted stroke (OR, 2.0; 95% CI, 1.1-3.6; P = .03), but CCAB did not.ConclusionsIn patients with symptomatic CAD, both clinical CAD severity and operative strategy affect outcomes. In SA patients, CCAB does not increase perioperative morbidity. However, CCAB in UA patients prevents MI while not appreciably increasing stroke risk. This suggests that coronary revascularization before or concomitant with CEA should be considered in UA patients but that prioritizing coronary intervention is less important in SA patients.     

双源CT头颈心一站式扫描对动脉粥样硬化的应用价值

目的探讨双源CT头颈心一站式扫描对动脉粥样硬化(AS)患者的应用价值。方法将120例AS患者随机分为2组,每组60例。对A组行头颈心一站式扫描,B组分别行常规冠状动脉CTA及头颈部血管CTA扫描。对2组图像质量进行主观及客观评价;主观评分采用3分法,客观评价指标包括左冠状动脉主干、右冠状动脉中段、颈总动脉近分叉处、颈内动脉C1段、大脑中动脉M1段血管的平均SNR及其相对于脊柱旁肌肉的CNR。记录2组CTA扫描长度、扫描时间、剂量长度乘积(DLP)和有效剂量(ED),并进行统计学分析。结果 2组图像质量评分差异无统计学意义(t=0.596,P=0.283),SNR及CNR差异亦无统计学意义(t=0.828、0.761,P=0.104、0.089)。2组间CTA扫描长度差异无统计学意义(t=1.351,P=0.621),但A组较B组扫描时间更短[(1.30±0.12)s vs (4.08±0.69)s,t=-2.831,P=0.006],DLP[(146.03±13.05)mGy·cm vs (1 935.04±134.12)mGy·cm,t=-6.743,P0.01]及ED[(0.88±0.32)mSv vs (9.62±1.64)mSv,t=-4.056,P0.01]更低。结论对AS患者,双源CT头颈心一站式扫描技术能获得满意的冠状动脉、头颈动脉图像,同时显著降低辐射剂量。     

迭代重建算法在肥胖患者冠状动脉CT成像中的应用

目的 与滤波反投影法(FBP)相比,观察正弦图确认的迭代重建算法(SAFIRE)可否改善肥胖患者冠状动脉CTA(CTCA)图像质量及有效降低辐射剂量.方法 连续收集49例接受CTCA的肥胖患者,对其中39例使用常规序列扫描(120 kV,A组),分别选用FBP(FBP亚组)和SAFIRE(SAFIRE亚组)重建;对另10例使用低剂量扫描序列(100 kV,B组),SAFIRE重建.比较各组间主观(冠状动脉评分)和客观图像质量(图像噪声,SNR,CNR)的差异.结果 SAFIRE亚组的图像噪声、SNR、CNR比均优于FBP亚组和B组(P＜0.05),但FBP亚组的图像主观评分与B组差异无统计学意义.B组的有效辐射剂量[(4.36±0.75) mSv]明显小于A组[(8.83±1.74) mSv] (P＜0.01).结论 与FBP相比,SAFIRE可显著提高相同剂量水平的CTCA图像质量,并能在降低约50％辐射剂量的条件下保证图像质量.     

Sequential multidetector computed tomography assessments after venous graft treatment solution in coronary artery bypass grafting

ObjectivesTo assess the effect of DuraGraft (Somahlution Inc, Jupiter, Fla), an intraoperative graft treatment, on saphenous vein grafts in patients undergoing isolated coronary artery bypass grafting.MethodsWithin patients, 2 saphenous vein grafts were randomized to DuraGraft or heparinized saline. Multidetector computed tomography angiography at 1, 3, and 12 months assessed change in wall thickness (primary end point at 3 months), lumen diameter, and maximum narrowing for the whole graft and the proximal 5-cm segment. Safety end points included graft occlusion, death, myocardial infarction, and repeat revascularization.ResultsAt 3 months, no significant changes were observed between DuraGraft- and saline-treated grafts (125 each) for wall thickness, lumen diameter, and maximum narrowing. At 12 months, DuraGraft-treated grafts demonstrated smaller mean wall thickness, overall (0.12 ± 0.06 vs 0.20 ± 0.31 mm; P = .02) and in the proximal segment (0.11 ± 0.03 vs 0.21 ± 0.33 mm; P = .01). Changes in wall thickness were greater in the proximal segment of saline-treated grafts (0.09 ± 0.29 vs 0.00 ± 0.03 mm; P = .04). Increase in maximum graft narrowing was larger in the proximal segment in the saline-treated grafts (4.7% ± 12.7% vs 0.2% ± 3.8%; P = .01). Nine DuraGraft and 11 saline grafts had occluded or thrombosed. One myocardial infarction was associated with a saline graft occlusion. No deaths or revascularizations were observed.ConclusionsDuraGraft demonstrated a favorable effect on wall thickness at 12 months, particularly in the proximal segment. Longer-term follow-up in larger studies is needed to evaluate the effect on clinical outcomes.     

双源CT低剂量扫描在颌面部骨折中的应用

目的探讨双源CT 100kV管电压低剂量扫描模式诊断颌面部骨折的应用价值。方法对100例颌面部外伤患者行颌面部双源CT扫描,并随机分成100kV组和120kV组,比较两组的辐射剂量和背景噪声,并对图像质量进行评价。结果 100kV组的有效辐射剂量[(0.39±0.01)mSv]低于120kV组[(0.64±0.03)mSv,t=55.902,P<0.001]。与120kV组比较,100kV组的有效辐射剂量下降了39.06%。100kV组图像的背景噪声[(29.3±4.0)HU]高于120kV组[(26.5±3.4)HU,t=3.771,P<0.001],但二者图像质量评分差异无统计学意义(P均>0.05)。结论双源CT低管电压扫描对图像质量无影响,而辐射剂量明显下降。