Flash双源CT大螺距冠状动脉成像与冠状动脉造影对比的临床研究

目的评价Flash双源CT大螺距前瞻性心电门控扫描模式（flashspril）诊断冠状动脉狭窄的准确性。方法30例患者行Flash双源CT冠状动脉成像（CTCA）后进行冠状动脉造影术（CCA）检查。以冠状动脉造影术结果作为金标准，统计Flash双源CTCA显示冠脉病变的敏感性、特异性、阳性预测值和阴性预测值，统计冠状动脉各段图像质量评分及有效射线剂量。结果①准确性评价：基于节段水平分析，敏感性93．2％，特异性96．8％，阳性预测值86．0％，阴性预测值98．5％。基于血管水平分析，敏感性97．9％，特异性83．8％，阳性预测值88．7％，阴性预测值96．8％。基于患者水平分析，敏感性、特异性、阳性预测值、阴性预测值均为100％。CTCA显示冠状动脉狭窄结果与CCA高度一致。②图像质量：右冠状动脉不可诊断血管节段占右冠状动脉的3．4％，左冠状动脉主干、前降支不可诊断血管节段为0，回旋支不可诊断血管节段低于1．0％。③射线剂量：平均有效射线剂量（1．72±0．10）mSv。结论Flash双源CTflashspril模式CTCA评价冠状动脉狭窄的准确性高，图像质量好，运动伪影小，有效射线剂量低。

The study of diagnostic accuracy of prospectively ECG-triggered high-pitch spiral acquisition using flash dual-source CT for the assessment of coronarys stenosis

Objective To prospectively investigate the diagnostic accuracy, image quality and radiation doses of prospectively ECG-triggered high-pitch spiral acquisition computed tomography coronary angiography （CTCA） using flash dual-source CT compared with catheter coronary angiography （CCA） for the diagnosis of sig- nificant coronary stenosis. Methods Thirty patients underwent both CTCA and CCA. CTCA was performed with a flash dual-source CT system permitting data acquisition at an high-pitch of 3.4. CCA served as the standard of reference. Radiation dose values were calculated using the dose-length product. Results The sensitivity, specificity and positive and negative predictive values were 93.2%, 96.8%, 86.0% and 98.5% per segment and 97.9%, 83.8%, 88.0% and 88.7% per vessel and 100% per patient. The rate of coronary segments with non-diagnostic image quality was 3.4% in right coronary artery and left circumflex artery below 1.0%. There were no non-diagnostic image quality in left anterior descending artery. The effective radiation dose was on average （1.72±0.10）mSv. Conclusion CTCA using the prospectively ECG-triggered high-pitch spiral mode of the flash dual-source CT system is associated with high diagnostic accuracy for the assessment of coronary artery stenosis at low doses.