双源CT胸痛序列心胸血管一站式低剂量成像探讨

目的探讨双源CT胸痛序列心胸血管一站式成像低剂量技术在急性胸痛征的临床价值。方法 102例临床要求行胸部血管检查的患者,采用胸痛序列血管成像。应用心电脉冲剂量调控技术,对不同的心率选择不同的全剂量曝光时间窗。心率≤75次/min,分为常规辐射剂量(A)组28例、低辐射剂量(B)组25例;心率76～120次/min,分为常规辐射剂量(C)组24例、低辐射剂量(D)组25例。对各组患者的肺动脉、冠状动脉、主动脉图像质量进行盲法评分,计算每例患者辐射有效剂量,并进行A组与B组、C组与D组比较。结果各辐射剂量组均获得满意图像,A与B组、C与D组图像质量评分差异均无统计学意义。有效剂量A组(7.09±0.95)mSv较B组(5.01±0.34)mSv高,差异有统计学意义(P<0.05);C组(4.79±0.91)mSv较D组(2.48±0.43)mSv高,差异有统计学意义(P<0.05)。结论对于急性胸痛的患者,在心率相对平稳的情况下,采用低剂量胸痛序列对冠状动脉、肺动脉、主动脉快速明确地诊断,为临床争取更多的治疗时间,具有重要的临床意义。

Low-dose Chest Pain Protocol for Cardiac and Chest Imaging using Dual-source Computed Tomography

Objective To evaluate the clinical value of low-dose chest pain protocol for cardiac and chest vascular imaging using dual-source computed tomography.Methods 102patients with requests for examinations of cardiac and thoracic blood vessels,were scanned in chest pain protocol for angiography.With heart electrical impulses dose control techniques,maximum tube current within the R-R interval was set up by different heart rate.Patients with a heart rate less than or equal to 75beats / min were divided into two groups : regular-dose group(A) 28patients;low-dose group(B) 25patients.Patient with a heart rate of 76-120beats / min were also divided into two groups : regular-dose group(C) 24patients;low-dose group(D) 25patients.The image quality of pulmonary artery,coronary artery and aortic were blind evaluated.The effective dose for each patient was calculated and group comparisons were made.Results Every radiation dose gained satisfactory images.No differences in image quality were found between Group A and Group B,and between Group C and Group D(P>0.05).The effective doses of Group A(7.09±0.95) mSv were significantly higher than those of Group B(5.01±0.34) mSv.The effective doses of Group C(4.79±0.91) mSv were significantly higher than those of Group D(2.48±0.43) mSv.Conclusion For patients with acute chest pain and relatively stable heart rate,their cardiac and thoracic vessels can be shown clearly in images of low-dose chest pain protocol,which provides a rapid and clear diagnostic instrument.