320排640层动态容积CT在急性胸痛检查中的初步探讨

目的:探讨320排640层动态容积CT胸痛三联检查的图像质量及临床价值。方法:连续选取38例急性胸痛患者行320排640层动态容积CT检查。扫描方案为心电门控下全胸部螺旋扫描(160 mm×0.5mm),采用智能自动触发技术。对比剂用量为80～90ml(碘海醇350)。分别由2位专业医生测定肺动脉干层面的升主动脉、降主动脉、肺动脉干CT值并评价冠脉质量,冠脉质量分为优、良、差三级。同时评价辐射剂量。结果:升主动脉、降主动脉、肺动脉平均CT值分别为(401±57)HU,(397±49)HU,(331±31)HU。冠状动脉图像质量优者占84.7%,良占13.2%,差占2.1%。共检出肺感染伴胸腔积液4例,肺癌1例,肺栓塞2例,主动脉夹层1例,心房粘液瘤2例。冠状动脉狭窄≥50%者12例。本组平均辐射剂量为(22±2.1)mSv。结论:本扫描方案可得到高质量的主动脉、肺动脉和冠状动脉图像,对比剂用量和患者辐射剂量较低。适用于急性胸痛病因诊断。

Primary Experiences in 320-Row-640-Slice Dynamic CT for Checking Acute Chest Pain

Objective:To evaluate the image quality and clinic value of dynamic CT checking triple rule-out.Method:38 patients suffering acute chest pain were continuously selected and accepted 320-row-640-slice dynamic CT examination.The scan protocol was helical scanning the whole chest,under ECG-gate,intelligent and automatically trigger.80～90ml contrast media was needed.Two professional doctors measure the CT value of ascending main aorta,decline main aorta and pulmonary artery separately in pulmonary trunk level.The image quality of coronary artery was evaluated,which was graded in three levels:good,well,bad.The dose of radiation was also evaluated.Result:The average CT value of ascending main aorta,decline main aorta and pulmonary artery was(401±57)HU,(397±49) HU,(331±31)HU.84.7%of all image quality of coronary artery were good,13.2%were well,2.1%were bad.4 patients were diagnosed lung infection with pleurar effusion,1 patient was lung cancer,2 patients pulmonary embolism,1 patient dissection of aorta,2 patients artrial myxoma.The degree of stenosis was more than 50%in 12 patients’ coronary artery.Average radiation dose was(22±2.1 )mSv. Conclusion:This scanning protocol can achieve high quality image of main aorta,pulmonary artery and coronary artery comparing with the reports of literature.It is very valuable for finding pathogen of acute chest pain.The dose of contrast media and radiation were lower.