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- 2018
可变螺距技术在320排CT急性胸痛三联检查中的应用
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Abstract:
摘要 目的:探讨可变螺距(VHP)技术在320排CT急性胸痛三联检查中的可行性.方法: 连续收集44例采用320排CT行胸痛三联检查的患者,与54例单独行320排CT主动脉成像、52例肺动脉成像及48例冠状动脉成像患者生成的图像分别进行对照,针对患者基本资料、图像质量及辐射剂量使用SPSS19.0软件进行统计学分析.结果: 两组患者性别构成比、年龄差异对比无统计学差异.三联组与对照组中主动脉、肺动脉及冠状动脉图像质量的优良率对比,均无统计学差异(P>0.05).三联组与对照组中降主动脉、右冠状动脉中段、左主干、左冠状动脉前降支近段、左冠状动脉前降支中段、左冠状动脉旋支近段及左冠状动脉旋支远段血管强化CT值不同,有统计学差异(P<0.05),以上所有血管增强CT值均大于300 HU.两组患者剂量长度乘积、有效剂量结果对比,均有统计学差异(P<0.05).结论: VHP技术可以一次扫描完成急性胸痛患者主动脉、肺动脉及冠状动脉的CT血管造影(CTA)检查.与单纯主动脉、肺动脉及冠状动脉CTA成像对比,图像质量无区别,对于急性胸痛病因的诊断具有极其重要的意义.
[1] | AUSTEN W G, EDWARDS J E, FRYE R L, et al.A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association[J]. Circulation, 1975,51(4 Suppl):5. |
[2] | 周玉祥, 蓝博文, 刘其顺, 等. 多层螺旋CT检测冠状动脉起源异常的价值[J]. 暨南大学学报(自然科学与医学版), 2012,33(4):414-417. |
[3] | ZHOU Y X, LAN B W, LIU Q S, et al.Value of multi-slice spiral CT in detection of coronary artery anomalies[J]. Journal of Jinan University (Natural Science & Medicine Edition), 2012,33(4): 414-417. |
[4] | QIU C H, FAN H Y, SHI Q Y.Diagnosis of acute chest pain with 64-slice spiral CT angiography in thoracic triad[J] Journal of Practical Radiology, 2012,28(10): 1534-1537. |
[5] | 李欣, 孙吉林, 戴国华, 等. 急性胸痛三联症64层螺旋CT“一站式成像”的研究[J]. 临床放射学杂志, 2011,30(7):974-978. |
[6] | 孙宏亮, 肖喜刚, 魏庆堂. 冠状动脉MSCT结合回顾性心电门控最佳容积重建相位的选择[J]. 临床放射学杂志, 2005,24(12):1059-1062. |
[7] | ZHAO L,BAO L L,WANG Z F, et al.Design and feasibility study of a new scanning protocol for triple-row CT scanning of chest pain with 64-slice spiral CT: One-station imaging of whole aorta, coronary artery and pulmonary artery[J].Journal of Radiology, 31(11): 1066-1070. |
[8] | HOU Y, YUE Y, GUO W, et al.Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography: image quality and radiation dose over expanded heart rates[J]. International Journal of Cardiovascular Imaging, 2012,28(1):153. |
[9] | 郭永梅, 谢琦, 江新青. 全程CTA扫描方法在诊断主动脉夹层中的应用[J]. 中国CT和MRI杂志, 2009,7(2):64-66. |
[10] | GUO Y M, XIE Q, JIANG X Q.Application of full CTA scanning in the diagnosis of aortic dissection[J].CTMT, 2009,7(2): 64-66. |
[11] | 王志强, 刘宏旭, 毕晓丽. 炫速双源冠状动脉CTA多种低剂量扫描模式在心律不齐中的临床应用[J]. 北华大学学报(自然), 2017,18(1):79-81. |
[12] | WANG Z Q, LIU H X, BI X L.Clinical application of various low-dose CTA scanning patterns in patients with arrhythmia with hyundai dual-source coronary artery CTA[J].Journal of Northwestern University (Natural), 2017,18(1): 79-81. |
[13] | 张雨洁, 俞同福, 梁静. 支气管动脉CTA对支气管动脉栓塞术的指导作用[J]. 中国介入影像与治疗学, 2015,12(8):472-476. |
[14] | ZHANG Y J, YU T F, L J. Guiding effect of bronchial artery CTA on bronchial artery embolization[J].Journal of Chinese Imaging Techniques and Remedies, 2015,12(8): 472-476. |
[15] | 齐晨晖, 范红燕, 史琼玉. 64排螺旋CT血管成像胸部三联检查对急性胸痛的诊断价值[J]. 实用放射学杂志, 2012,28(10):1534-1537. |
[16] | LI X, SUN J L, DAI G H, et al.Acute chest pain triad 64-slice spiral CT “one-stop imaging”[J]. Journal of Clinical Radiology, 2011,30(7): 974-978. |
[17] | TANG L Z, JIANG H, WU B J, et al.Application of dual-source CT large-pitch forward scanning in the imaging of chest pain triad[J].Journal of Medical Imaging of China, 2015,23(3): 200-203. |
[18] | BOZZANI A, PALMIERI P, ARICI V, et al.Re: acute aortic syndrome: CT findings[J]. Clinical Radiology, 2013,68(7):741-748. |
[19] | 田冰, 陆建平, 许兵, 等. VHP法在主动脉、冠状动脉及肺动脉一站式成像中的应用研究[J]. 放射学实践, 2014,29(4):400-403. |
[20] | TIAN B, LU J P, XU B, et al.Application of VHP in one-stop imaging of aorta, coronary artery and pulmonary artery[J].Radiology Practice, 2014,29(4): 400-403. |
[21] | 张蕴, 荐志洁, 赵婷婷, 等. 64层螺旋CT胸痛“三联”CTA技术与诊断价值[J]. 中国医学影像技术, 2013,29(12):2036-2040. |
[22] | ZHANG Y, ZHI Z J, ZHAO T T, et al.“Three” CTA technique and diagnostic value of 64-slice spiral CT chest pain[J].Medicine of China Imaging Technology, 2013,29(12): 2036-2040. |
[23] | 赵磊, 包丽丽, 王泽锋, 等. 64层螺旋CT胸痛三联排查扫描的新扫描协议设计与可行性研究:全主动脉、冠状动脉与肺动脉一站式成像[J]. 放射学实践, 2016,31(11):1066-1070. |
[24] | SUN H L,XIAO X G,WEI Q T, et al.Coronary artery MSCT combined with retrospective ECG-optimal volume reconstruction phase selection[J]. Journal of Clinical Radiology, 2005,24(12): 1059-1062. |
[25] | LITMANOVICH D, ZAMBONI G A, HAUSER T H, et al.ECG-gated chest CT angiography with 64-MDCT and tri-phasic IV contrast administration regimen in patients with acute non-specific chest pain[J]. European Radiology, 2008,18(2):318. |
[26] | 汤连志, 姜洪, 吴宝金, 等. 双源CT大螺距前瞻扫描在胸痛三联症成像中的应用[J]. 中国医学影像学杂志, 2015,23(3):200-203. |
[27] | 李景雷, 黄美萍, 崔燕海, 等. 冠状动脉-肺动脉瘘多排螺旋CT征象分析[J]. 暨南大学学报(自然科学与医学版), 2013,34(2):221-225. |
[28] | LI J L, HUANG M P, CUI Y H, et al.Analysis of multislice spiral CT signs of coronary-pulmonary arterial fistula[J].Journal of Jinan University Natural Science & Medicine Edition, 2013,34(2): 221-225. |
[29] | FLEISCHMANN D, MITCHELL R S, MILLER D C.Acute aortic syndromes: new insights from electrocardiographically gated computed tomography[J]. Seminars in Thoracic & Cardiovascular Surgery, 2008,20(4):340. |
[30] | 武宝华, 田宏哲, 习羽, 等. 64排CTA在主动脉夹层DeBakeyⅠ-Ⅲ型中的诊断价值研究[J]. 中国CT和MRI杂志, 2015,8(10):57-60. |
[31] | WU B H, TIAN H Z, XI Y, et al.64 rows of CTA in the diagnosis of aortic dissection DeBakey Ⅰ-Ⅲ type[J]. China CT and MRI, 2015,8(10): 57-60. |
[32] | GOITEIN O, MATETZKY S, ESHET Y, et al.Coronary CT angiography for acute chest pain triage: techniques for radiation exposure reduction; 128 vs. 64 multidetector CT[J]. Acta Radiologica, 2011,52(8):840-845. |