Bastarrika G, Arraiza M, Arias J, Broncano J, Zudaire B, Pueyo J C, García del Barrio L
Servicio de Radiología, Clínica Universidad de Navarra, Pamplona, España.
Radiologia. 2009 Jul-Aug;51(4):376-84. doi: 10.1016/j.rx.2008.11.001. Epub 2009 Mar 17.
To evaluate the effect of average heart rate on the quality of images of the coronary arteries and to determine the optimal reconstruction interval in nonselected patients undergoing DSCT coronary imaging.
We studied 28 consecutive subjects (26 men, 2 women; mean age 60+/-12 years) undergoing contrast-enhanced DSCT (Somatom Definition, Siemens) coronary angiography. Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers assessed the image quality of the whole coronary tree and of each coronary artery using a four-point scale (1: impossible to evaluate, 4: excellent quality).
Mean heart rate during scanning was 73.1+/-14.8 bpm (range, 49-107 bpm). In the best reconstruction interval, excellent diagnostic image quality (score 4) was achieved for 98.8% (83/84) of coronary arteries. Very good interobserver agreement was observed for image quality rating (kappa=0.77) and for selection of the optimal reconstruction interval (kappa=0.86). Mean image quality score for the whole coronary tree was 2.84+/-0.31. No significant correlation was found between the average heart rate and the mean quality scores (r=0.108). No significant differences were found in the quality of images of the coronary arteries in systolic and diastolic reconstructions in each patient.
DSCT makes it possible to obtain excellent coronary angiograms independent of the heart rate. Reconstructions can be obtained in either the diastolic or systolic phase without significant differences in image quality, even at high heart rates.
评估平均心率对冠状动脉图像质量的影响,并确定未选择的接受双源CT(DSCT)冠状动脉成像患者的最佳重建间隔。
我们研究了28例连续接受对比增强DSCT(西门子Somatom Definition)冠状动脉造影的受试者(26名男性,2名女性;平均年龄60±12岁)。数据集在R-R间期的30%至80%范围内以5%的步长重建。两名独立的盲法阅片者使用四点量表(1:无法评估,4:质量极佳)评估整个冠状动脉树和各冠状动脉的图像质量。
扫描期间的平均心率为73.1±14.8次/分钟(范围49 - 107次/分钟)。在最佳重建间隔下,98.8%(83/84)的冠状动脉实现了极佳的诊断图像质量(评分4)。在图像质量评级(kappa = 0.77)和最佳重建间隔的选择(kappa = 0.86)方面,观察者间具有很好的一致性。整个冠状动脉树的平均图像质量评分为2.84±0.31。平均心率与平均质量评分之间未发现显著相关性(r = 0.108)。每位患者在收缩期和舒张期重建的冠状动脉图像质量无显著差异。
双源CT能够独立于心率获得极佳的冠状动脉造影图像。即使在高心率情况下,无论是在舒张期还是收缩期进行重建,图像质量均无显著差异。