使用16排和64排同步探测器的CT冠状动脉造影：个体内比较

CT coronary angiography using 16 and 64 simultaneous detector rows: intraindividual comparison.

作者信息

Dewey M, Hoffmann H, Hamm B

机构信息

Radiologie, Charité, Berlin.

出版信息

Rofo. 2007 Jun;179(6):581-6. doi: 10.1055/s-2007-963112. Epub 2007 May 9.

DOI:10.1055/s-2007-963112

PMID:17492543

Abstract

PURPOSE

Multislice computed tomography (MSCT) is an emerging noninvasive technique for detecting coronary artery stenoses. An intraindividual study comparing 16- and 64-slice CT coronary angiography is highly desirable but has not been performed thus far. We sought to intraindividually compare MSCT using 16 and 64 simultaneous detector rows for noninvasive coronary angiography.

MATERIALS AND METHODS

A total of 33 patients (23 men, 10 women) underwent MSCT coronary angiography using both 16 x 0.5 and 64 x 0.5 mm detector collimation at an interval of 2.1 +/- 0.4 years and were included in this head-to-head evaluation. A comparison of the image quality of noninvasive coronary angiography and effective radiation dose was performed.

RESULTS

The overall coronary vessel lengths visualized and the vessel lengths depicted free of motion artifacts were significantly longer using 64-slice CT compared to 16-slice CT for the left anterior descending (134 +/- 28 vs. 115 +/- 40 mm and 128 +/- 34 vs. 113 +/- 41 mm), left circumflex (106 +/- 31 vs. 90 +/- 39 mm and 105 +/- 30 vs. 86 +/- 36 mm), and right coronary artery (153 +/- 33 mm vs. 137 +/- 47 mm and 142 +/- 44 mm vs. 107 +/- 61 mm) (all: p < 0.05). The overall subjective image quality on a 5-point scale (5 = maximum quality, 1 = minimum quality) was also significantly (p < 0.001) higher with 64-slice than with 16-slice CT for vessel contrast (4.6 +/- 0.7 vs. 4.1 +/- 1.0, p < 0.001), vessel continuity (4.8 +/- 0.6 vs. 4.5 +/- 1.1, p < 0.001), and the depiction of coronary sidebranches (4.9 +/- 0.3 vs. 4.6 +/- 1.1, p < 0.001). The improvement in image quality was mainly due to a significant reduction in the breathhold time necessary for 64-slice CT (8.9 +/- 0.9 sec vs. 28.5 +/- 4.6 sec, p < 0.001). The amount of intravenous contrast agent required was significantly smaller with 64-slice CT (80 +/- 6 ml vs. 108 +/- 11 ml, p < 0.001), while the effective radiation dose was significantly higher for 64-slice CT (16.9 +/- 2.4 mSv vs. 12.1 +/- 2.1 mSv, p < 0.001).

CONCLUSION

The results indicate that MSCT coronary angiography using 64 simultaneous detector rows yields higher image quality for depiction of the coronary arteries and entails a lower intravenous contrast agent amount but higher radiation exposure.

摘要

目的

多层螺旋计算机断层扫描（MSCT）是一种新兴的用于检测冠状动脉狭窄的无创技术。一项比较16层和64层CT冠状动脉造影的个体内研究非常有必要，但迄今为止尚未开展。我们试图在个体内比较使用16排和64排同步探测器行MSCT进行无创冠状动脉造影的情况。

材料与方法

共有33例患者（23例男性，10例女性）接受了MSCT冠状动脉造影，分别使用16×0.5和64×0.5mm探测器准直，间隔时间为2.1±0.4年，并纳入了此次直接比较评估。对无创冠状动脉造影的图像质量和有效辐射剂量进行了比较。

结果

与16层CT相比，64层CT显示的左前降支（134±28 vs. 115±40mm和128±34 vs. 113±-41mm）、左旋支（106±31 vs. 90±39mm和105±30 vs. 86±36mm）以及右冠状动脉（153±33mm vs. 137±47mm和142±44mm vs. 107±61mm）的总体冠状动脉长度以及无运动伪影的血管长度均显著更长（所有：p<0.05）。在5分制（5=最高质量，1=最低质量）下，64层CT在血管对比度（4.6±0.7 vs. 4.1±1.0，p<0.001）、血管连续性（4.8±0.6 vs. 4.5±1.1，p<0.001）以及冠状动脉分支显示（4.9±0.3 vs. 4.6±1.1，p<0.001）方面的总体主观图像质量也显著高于16层CT（p<0.001）。图像质量的提高主要是由于64层CT所需屏气时间显著缩短（8.9±0.9秒 vs. 28.5±4.6秒，p<0.001）。64层CT所需静脉造影剂的量显著更少（80±6ml vs. 108±11ml，p<0.001），而64层CT的有效辐射剂量显著更高（16.9±2.4mSv vs. 12.1±2.1mSv，p<0.001）。