Cao Guoquan, Chen Weijian, Pan Kehua, Sun Houchang, Wang Zhen
1 Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
2 Department of Radiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang Province, China.
J Int Med Res. 2019 May;47(5):1916-1926. doi: 10.1177/0300060519825986. Epub 2019 Feb 27.
The aim of this study was to compare the feasibility of 640-slice with 64-slice computed tomography (CT) coronary angiography for diagnosing coronary lesions in patients with pacemakers.
Forty-five and 50 patients with pacemakers and with suspected or known coronary artery disease underwent 64-slice (64 group) and 640-slice (640 group) CT scans, respectively. All segments of the vessels were evaluated according to the 15-segment model recommended by the American Heart Association.
The incidence of moderate or severe artifacts was significantly lower (7.27% vs. 32.17%) and the diagnosable rate for coronary lesions was higher (98.91% vs. 94.19%) in the 640 compared with the 64 group. In the 64 group, the incidence of artifacts in patients with a heart rate >65 bpm (20.98%) was higher than in those with a heart rate <65 bpm (15.67%), although the difference was not significant, while the incidence of artifacts was significantly higher in patients with heart arrhythmia (21.40%) compared with in those with normal heart rhythm (15.09%).
Among patients with pacemakers and a higher heart rate or heart arrhythmia, 640-slice CT may be more effective than 64-slice CT for diagnosing coronary lesions, by reducing moderate and severe artifacts.
本研究旨在比较640层与64层计算机断层扫描（CT）冠状动脉造影在诊断起搏器患者冠状动脉病变方面的可行性。
45例和50例有起搏器且疑似或已知患有冠状动脉疾病的患者分别接受了64层（64组）和640层（640组）CT扫描。根据美国心脏协会推荐的15段模型对血管的所有节段进行评估。
与64组相比，640组中度或重度伪影的发生率显著更低（7.27%对32.17%），冠状动脉病变的可诊断率更高（98.91%对94.19%）。在64组中，心率>65次/分的患者伪影发生率（20.98%）高于心率<65次/分的患者（15.67%），尽管差异不显著，而心律失常患者的伪影发生率（21.40%）显著高于心律正常的患者（15.09%）。
在有起搏器且心率较高或有心律失常的患者中，640层CT通过减少中度和重度伪影，在诊断冠状动脉病变方面可能比64层CT更有效。
