两种方法控制64排螺旋CT冠状动脉成像中心率的比较

目的: 通过两组病例的对比研究，探讨控制患者检查前的心率和效果。方法: 基础心率大于70次/min的患者654例，分为药物干预组352例和心理干预组302例，进行不同的心率干预措施后行64排螺旋CT冠状动脉成像，将两组患者的心率控制效果，冠状动脉图像质量及图像后处理的时间进行比较。结果: 经过口服倍他乐克减慢和稳定心率后， 340例（96.6%）心率降至70次/min以下,12例（3.4%）口服倍他乐克者未降至目标心率。352例患者中有347例（98.8%）的整体图像能满足诊断要求。心理干预组127例（42.0%）经过给予心理护理后心率降至70次/min 以下，154例（58.0%）未降至目标心率。302例患者中266例（88%）能满足诊断要求。控制组图像后处理的平均时间为（12±5）min，对照组图像后处理的平均时间为（18±6）min。结论: 倍他乐克可降低心率明显提高冠状动脉CTA的成像质量，药物控制心率优于心理护理。

Study on heart rate control and coronary artery imaging using 64-slice helical CT

AIM: To study methods to control heart rate so as to obtain good image quality and accurate diagnosis in 64-slice CT coronary angiography. METHODS: Six hundred and fifty-four consecutive patients (control group with beta blocker, 352 cases; contrast group with mental intervention, 302 cases) with heart rate >75 beats/min underwent 64-slice CT coronary angiography. Image quality and postprocessing time between groups were compared. RESULTS: After taking measures to decrease and stabilize the heart rate, the heart rate decreased <70 beats/min in 340 patients (96.6%) except 12 (3.4%) in the control group. Coronary arteries of 347 patients (98.8%) were assessable. For the contrast group, 127 cases (42%) decreased <70 beats/min. Diagnostic results were obtained in 266/302 patients (88%). The mean postprocessing time was (12±5)min for the control group and (18±6)min for the contrast group. CONCLUSION: Heart rate has a vital impact on the coronary CTA image quality. Beta blocker reduces the heart rate and thus significantly improves the CTA image quality. Administration of medication is better than mental intervention in controlling heart rate.