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先天性心脏病婴儿心脏128层CT与心脏64层CT冠状动脉显影及辐射剂量评估

Assessments of Coronary Artery Visibility and Radiation Dose in Infants with Congenital Heart Disease on Cardiac 128-slice CT and on Cardiac 64-slice CT.

作者信息

Cui Y, Huang M, Zheng J, Li J, Liu H, Liang C

机构信息

Southern Medical University, Tonghe, Guangzhou, 510515, China.

Department of Radiology, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Zhongshan 2nd Road 106#, Guangzhou, 510080, China.

出版信息

Pediatr Cardiol. 2016 Jan;37(1):135-43. doi: 10.1007/s00246-015-1252-z. Epub 2015 Aug 14.

Abstract

The aim of this study was to compare the coronary artery visibility and radiation dose in infants with CHD on cardiac 128-slice CT and on cardiac 64-slice CT. The images of 200 patients were analyzed in this study, 100 patients were selected randomly from a group of 789 infants (<1 years old) with CHD undergoing 128-slice CT prospective ECG-triggered axial scan, and 100 were selected randomly from 911 infants with CHD undergoing 64-slice CT retrospective ECG-gated spiral scan. The visibility of coronary artery segments was graded on a four-point scale. The coronary arteries were considered to be detected or visible when grade was 2 or higher. The visibility of the coronary artery segments and the radiation dose was compared between the two groups. Except for the rate of LM (96 vs. 99%), the detection rates of the total, LAD, LCX, RCA, and the proximal segment of the RCA in the 256-slice CT group were significantly higher than those in the 64-slice CT group (51.7, 53.33, 33.67, 53.33, and 99 vs. 34.8, 34.33, 18, 30.67, and 75%, respectively). The counts of visibility score (4/3/2/1) for the LM and the proximal segment of the RCA were 62/22/12/4 and 56/20/17/7, respectively, in the 128-slice CT group and 17/42/30/1 and 9/30/38/25, respectively, in the 64-slice CT group. There were significant differences, especially for score 4 and 3, between the two groups. The radiation dose in the 128-slice CT group was significantly decreased than those in the 64-slice CT group (CTDIvol 1.88 ± 0.51 vs. 5.61 ± 0.63 mGy; SSDE 4.48 ± 1.15 vs. 13.97 ± 1.52 mGy; effective radiation dose 1.36 ± 0.44 vs. 4.06 ± 0.7 mSv). With reduced radiation dose, the visibility of the coronary artery in infants with CHD via prospective ECG-triggered mode on a 128-slice CT is superior to that of the 64-slice CT using retrospective ECG-gated spiral mode.

摘要

本研究的目的是比较先天性心脏病(CHD)婴儿在心脏128层CT和心脏64层CT上的冠状动脉显影情况及辐射剂量。本研究分析了200例患者的图像,其中100例患者从789例年龄小于1岁的CHD婴儿组中随机选取,这些婴儿接受128层CT前瞻性心电图触发轴位扫描,另外100例从911例接受64层CT回顾性心电图门控螺旋扫描的CHD婴儿中随机选取。冠状动脉节段的显影情况按四点量表分级。当分级为2级或更高时,冠状动脉被认为可检测到或可见。比较了两组之间冠状动脉节段的显影情况和辐射剂量。除左主干(LM)检出率(96%对99%)外,256层CT组的总检出率、左前降支(LAD)、左旋支(LCX)、右冠状动脉(RCA)及RCA近端节段的检出率均显著高于64层CT组(分别为51.7%、53.33%、33.67%、53.33%和99%对34.8%、34.33%、18%、30.67%和75%)。128层CT组中LM和RCA近端节段的显影评分(4/3/2/1)计数分别为62/22/12/4和56/20/17/7,64层CT组分别为17/42/30/1和9/30/38/25。两组之间存在显著差异,尤其是4分和3分的情况。128层CT组的辐射剂量显著低于64层CT组(容积CT剂量指数[CTDIvol] 1.88±0.51 mGy对5.61±0.63 mGy;大小体素剂量估计[SSDE] 4.48±1.15 mGy对13.97±1.52 mGy;有效辐射剂量1.36±0.44 mSv对4.06±0.7 mSv)。在降低辐射剂量的情况下,CHD婴儿通过128层CT前瞻性心电图触发模式的冠状动脉显影优于64层CT使用的回顾性心电图门控螺旋模式。

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