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在慢性阻塞性肺疾病(COPD)患者的冠状动脉计算机断层扫描血管造影(CTA)中,采用心率依赖和自由呼吸扫描方案减少造影剂用量。

Reduced contrast agent volume using a heart-rate dependent and free-breathing scanning protocol in coronary computed tomography angiography (CTA) for patients with chronic obstructive pulmonary disease (COPD).

作者信息

Wang Zengkun, Chen Guoyue, Song Dewei, Xu Xiaodie, Chu Chu, Zhang Shuning, Chai Huijing, Yu Hairong, Luan Xiaomei, Song Peiji

机构信息

Shandong Second Medical University, Weifang City, Shandong Province, China.

Department of Radiology, Central Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province, China.

出版信息

BMC Cardiovasc Disord. 2025 Jan 10;25(1):15. doi: 10.1186/s12872-024-04437-2.

Abstract

BACKGROUND

The personalized, free-breathing, heart rate-dependent computed tomography angiography (CTA) protocol can significantly reduce the utilization of contrast medium (CM). This proves especially beneficial for patients with chronic obstructive pulmonary disease (COPD) undergoing coronary artery CTA examinations.

OBJECTIVE

The aim of this study was to evaluate the feasibility of a personalized CT scanning protocol that was tailored to patients' heart rate and free-breathing for coronary CTA of patients with COPD.

METHODS

A total of 400 patients with COPD who need to undergo the coronary CTA were prospectively randomized into two groups (patients with vascular occlusion were excluded). Group A (n = 200) underwent CTA following a traditional protocol (70mL). The timing of the scans in Group B (n = 200) was determined according to the patient's HR and free-breathing (30mL).

RESULTS

No difference was found between the two groups in the CT values of RCA, LA, or LCX; (p = 0.131, 0.195 and 0.116). Subjective ratings of image quality (Table 2) were not statistically different between the two groups (p = 0.825).

CONCLUSION

By adopting a heart-rate dependent and free-breathing protocol, the contrast medium volume were reduced in coronary CTA for patients with COPD, while the image quality was remained comparable to those acquired with routine CTA protocol.

摘要

背景

个性化、自由呼吸、心率依赖性计算机断层扫描血管造影(CTA)方案可显著降低造影剂(CM)的用量。这对接受冠状动脉CTA检查的慢性阻塞性肺疾病(COPD)患者尤为有益。

目的

本研究旨在评估一种根据患者心率和自由呼吸量身定制的个性化CT扫描方案用于COPD患者冠状动脉CTA的可行性。

方法

总共400例需要进行冠状动脉CTA的COPD患者被前瞻性随机分为两组(排除血管闭塞患者)。A组(n = 200)按照传统方案(70mL)进行CTA检查。B组(n = 200)根据患者心率和自由呼吸情况确定扫描时间(30mL)。

结果

两组之间右冠状动脉(RCA)、左心房(LA)或左回旋支(LCX)的CT值无差异;(p = 0.131、0.195和0.116)。两组之间图像质量的主观评分(表2)无统计学差异(p = 0.825)。

结论

通过采用心率依赖性和自由呼吸方案,COPD患者冠状动脉CTA中的造影剂用量减少,而图像质量与常规CTA方案获得的图像质量相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26f4/11721589/5f503a3560de/12872_2024_4437_Figa_HTML.jpg

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