Pan Chang-Jie, Qian Nong, Wang Tao, Tang Xiao-Qiang, Xue Yue-Jun
Department of Radiology, The Second People's Hospital of Changzhou, Nanjing Medical University, Changzhou, Jiangsu 213003, P.R. China.
Exp Ther Med. 2013 Feb;5(2):636-642. doi: 10.3892/etm.2012.828. Epub 2012 Nov 23.
The aim of this study was to evaluate the accuracy of using second generation dual-source CT (DSCT) to obtain high quality images and diagnostic performance and to reduce the radiation dose in adaptive prospective electrocardiography (ECG)-triggered sequence (CorAdSeq) CT coronary angiography (CTCA) without heart rate control. No prescan β-blockers were administered. Un-enhanced CT and CTCA with adaptive prospective CorAdSeq scanning without heart rate control were performed in 683 consecutive patients divided into two body mass index (BMI) groups: BMI <25 kg/m(2) (group A, n=412) and BMI ≥25 kg/m(2) (group B, n=271). The image quality and quantitative stenosis of all coronary segments with a diameter ≥1 mm were assessed. The mean heart rate (MHR), heart rate variability (HRV) and radiation dose values were recorded. In 426 cases, the diagnostic performance was evaluated using quantitative conventional coronary angiography as the reference standard. Diagnostic image quality was obtained in 98.5% of segments in group A and in 98.8% of segments in group B, with no significant differences between the groups. No correlations were observed between the image quality score and MHR or HRV (P=0.492, P=0.564, respectively). The effective radiation doses in groups A and B were 2.57±1.01 mSv and 6.36±1.88 mSv, respectively. The sensitivities and specificities of diagnosing coronary heart disease per patient were 99.6% and 97.8% in group A and 99.5% and 97.5% in group B, respectively (P>0.05). Adaptive prospective CorAdSeq scanning, without heart rate control, by second generation DSCT had a high image quality and diagnostic performance for coronary artery stenosis with lower radiation doses.
本研究的目的是评估在不控制心率的情况下，使用第二代双源CT（DSCT）获取高质量图像和诊断性能，并降低自适应前瞻性心电图（ECG）触发序列（CorAdSeq）CT冠状动脉造影（CTCA）辐射剂量的准确性。未给予预扫描β受体阻滞剂。对683例连续患者进行了非增强CT和无心率控制的自适应前瞻性CorAdSeq扫描的CTCA检查，这些患者分为两个体重指数（BMI）组：BMI<25kg/m²（A组，n=412）和BMI≥25kg/m²（B组，n=271）。评估了所有直径≥1mm冠状动脉节段的图像质量和定量狭窄情况。记录平均心率（MHR）、心率变异性（HRV）和辐射剂量值。在426例病例中，以定量传统冠状动脉造影作为参考标准评估诊断性能。A组98.5%的节段和B组98.8%的节段获得了诊断图像质量，两组之间无显著差异。图像质量评分与MHR或HRV之间未观察到相关性（P分别为0.492和0.564）。A组和B组的有效辐射剂量分别为2.57±1.01mSv和6.36±1.88mSv。A组和B组每位患者诊断冠心病的敏感性和特异性分别为99.6%和97.8%以及99.5%和97.5%（P>0.05）。第二代DSCT在不控制心率的情况下进行自适应前瞻性CorAdSeq扫描，对冠状动脉狭窄具有高图像质量和诊断性能，且辐射剂量较低。
