前瞻性心电门控在64层CT冠状动脉成像的初步应用

目的 评价前瞻性心电门控64层CT冠状动脉成像的可行性和临床应用价值.方法 60例患者进行前瞻性心电门控64层CT冠状动脉成像检查,分析有效辐射剂量,并采用多平面重组(MPR)、最大密度投影(MIP)、曲面重组(CPR)及容积再现(VR)技术显示冠状动脉,评价其成像质量.结果 平均辐射剂量(2.7±0.2)mSv;符合诊断标准的冠状动脉节段为93.3%(720/772),44.2%(341/772)质量优秀,49.1%(379/772)质量中等,6.7%(52/772)质量较差.冠状动脉重度狭窄(＞75%)或闭塞5例(8.3%),中度狭窄(50%～75%)17例(28.4%),管腔不规则或轻度狭窄(＜50%)18例(30.0%),冠状动脉正常者20例(33.3%).结论 前瞻性心电门控64层CT冠状动脉成像的影像质量能达到诊断标准,大大降低了辐射剂量,具有很好的临床应用价值.

64-slice spiral CT coronary angiography with prospective electrocardiogram-gating:an initial study

Objective To evaluate the feasibility of prospective electrocardiogram(ECG)-gating computed tomography coronary angiography(CTCA).Methods Sixty patients with suspected or known coronary artery disease underwent 64-slice CTCA using prospective ECG-gating.Multi-planar reconstruction (MPR),curved-planar reconstruction(CPR),maximum intensity projection(MIP)and volume rendering (VR)were used to demonstrate the coronary arteries.The image quality and radiation dose was evaluated.Results The mean effective radiation dose was(2.7±0.2)mSv.93.3%(720/772)segments of all coronary arteries were of diagnostic image quality,44.2%(341/772)Was classified as excellent and 49.1%(379/772)was good.Non-diagnostic coronary segments were found in 6.7%(52/772)of all coronary arteries.Therewere 5(8.3%)cases with severe coronary stenosis(＞75%)or occlusion,17(28.4%)cases with moderate stenosis(50%-75%),18(30.0%)cases with mild stenosis(＜50%)or irregular lumen,20(33.3%)cases with normal coronary artery.Conclusion With a low radiation dose,prospective electrocardiogram(ECG)-gated coronary 64-MSCT angiography has a good potential for the detection of coronary stenosis,especially for excluding coronary artery disease.