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双源CT前瞻性心电门控序列扫描冠状动脉成像准确性的多中心研究
引用本文:毕涛,徐磊,张兆琪,杨琳,赵蕾,吕滨,韩丹,柳澄,段青.双源CT前瞻性心电门控序列扫描冠状动脉成像准确性的多中心研究[J].中华放射学杂志,2004,43(1):708-713.
作者姓名:毕涛  徐磊  张兆琪  杨琳  赵蕾  吕滨  韩丹  柳澄  段青
作者单位:首都医科大学附属北京安贞医院影像科,100029;中国医学科学院北京协和医学院阜外心血管病医院放射科;昆明医学院第一附属医院放射科;山东省医学影像学研究所;福建医科大学附属协和医院放射科;
摘    要:Objective To investigate the accuracy of low-dose dual-source computed tomography (DSCT) coronary angiography in the step-and-shoot (SAS) mode for the diagnosis of coronary artery stenosis in comparison with conventional coronary angingraphy (CCA).Methods Prospective multiple-center study, 46 patientsmean age(58±9) years;bedy mass index(BMI) (25±3) kg/m2]underwent both DSCT in the SAS mode and CCA within 14 days.The inclusion criteria for contrast-enhanced CT: (1) heart rate less than 65 times/rain (bpm).(2) regular sinus rhythm, heart rate fluctuations within the range of 6 bpm. (3) holding breath well, breath-hold time is about 12-15 s.The exclusion criteria:(1) allergy to iodinecontaining contrast medium, nephropathy (serum creatinine level 120 μmol/L), heart failure and serious arrhythmias.(2) patients with coronary stents or bypass grafts.(3) heart rate can not be controlled very well (4)the patient could not take nitroglycerin.(5)BMI 30 kg/m2.(6) other heart disease: carcliomyopathy, valvular disease etc.Sensitivity, specificity, negative (NPV) and positive predictive value (PPV) were determined with CCA as standard of reference.The Kappa value between the two modalities and the two observers was calculated.Radiation dose values were measured.Results Mean heart rate during scanning was (61±6)bpm.99.19% (614/619) coronary segments were depicted with a diagnostic image quality. The vessel-based sensitivity, specificity, PPV, and NPV for the diagnosis of coronary artery stenosis were 96.2% (75/78), 88.2% (60/68), 90.4% (75/83), and 95.2% (60/63), respectively.The Kappa value between the two modalities was 0.848 (P=0.000).The mean effective dose of the SAS-CTCA was (2.95± 0.96) rosy(1.26-4.32 mSy).Conclusion In selected patients, DSCT coronary angiography in the SAS mode have good image quality, which allows for the accurate diagnosis of coronary stenosis at a low radiation dose.

关 键 词:辐射剂量    体层摄影术  X线计算机    冠状血管造影术    

Multiple center study about the reliability of the low-dose dual-source CT coronary angiography in the step-and-shoot mode
Abstract:
Keywords:Radiation dosageTomography  X-ray computedCoronary angiography
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