论文部分内容阅读
目的高心率伴单发室性期前收缩(ventricular premature beats,VPBs)患者冠脉CT血管成像(coronary computed tomography angiography,CCTA)中自适应前瞻性心电门控的应用价值。方法对扫描前心电监测显示单发VPBs的高心率患者(80bpm≤HR≤120bpm)使用自适应前瞻性心电门控技术进行冠状动脉CTA扫描,其中CTA扫描过程中出现单发VPBs的患者纳入单发VPBs组,CTA扫描时未出现VPBs的患者纳入未出现VPBs组;对扫描前心律整齐的高心率患者(80bpm≤HR≤120bpm)使用回顾性心电门控技术进行扫描,CTA扫描时心律整齐者纳入对照组。比较单发VPBs组、未出现VPBs组和对照组之间的图像质量评分、可诊断率以及有效辐射剂量。结果单发VPBs组、未出现VPBs组和对照组的冠状动脉图像质量评分分别为(3.4±0.8)、(3.4±0.7)、(3.2±0.8)分。单发VPBs组、未出现VPBs组冠状动脉图像质量差异无统计学意义(P=0.989),单发VPBs组、未出现VPBs组冠状动脉图像质量高于对照组(P=0.000);单发VPBs组、未出现VPBs组和对照组的可诊断率的分别为91.5%、89.1%、87.6%,单发VPBs组可诊断率高于对照组(P=0.040),其余两组间可诊断率的差异无统计学意义(P>0.05);单发VPBs组、未出现VPBs组、对照组的有效辐射剂量分别为(3.4±0.8)、(3.4±0.7)、(10.5±2.1)mSv,单发VPBs组、未出现VPBs组低于对照组(P=0.000)。结论自适应前瞻性心电门控技术可以有效降低高心率伴单发VPBs患者在冠状动脉CTA检查中接受的辐射剂量,并且有利于提高冠状动脉图像质量。
Objective To investigate the value of adaptive prospective ECG gating in coronary computed tomography angiography (CCTA) with high heart rate and single ventricular premature beats (VPBs). Methods Pre-scan ECG monitoring showed high-heart rate patients with single-episode VPBs (80bpm ≤ HR ≤ 120bpm) using an adaptive prospective electrocardiographic gating technique for coronary CTA scans, with inclusion of patients with single VPBs during CTA scanning Single VPBs group, patients without VPBs on CTA scan were enrolled in the group without VPBs; Patients with high heart rate before the scan (80bpm≤HR≤120bpm) were retrospectively scanned by ECG; Neatly included in the control group. Compared with the single VPBs group, there was no image quality score, diagnostic rate and effective radiation dose between the VPBs group and the control group. Results Coronary artery image quality scores of VPBs group without VPBs and control group were (3.4 ± 0.8), (3.4 ± 0.7) and (3.2 ± 0.8) points, respectively. In single VPBs group, there was no significant difference in the quality of coronary arteries between VPBs group and non-VPBs group (P = 0.989). In single VPBs group, the image quality of coronary arteries in VPBs group was higher than that in control group (P = 0.000) The diagnostic rates of VPBs group and control group were 91.5%, 89.1%, 87.6%, respectively. The diagnostic rates of single VPBs group were higher than those of the control group (P = 0.040). The diagnostic rates of the other two groups (P> 0.05). In the VPBs group, no VPBs group was found. The effective radiation doses in the control group were (3.4 ± 0.8), (3.4 ± 0.7) and (10.5 ± 2.1) mSv, VPBs group, VPBs group did not appear lower than the control group (P = 0.000). Conclusions Adaptive prospective electrocardiographic gating technique can effectively reduce the dose of radiation in coronary heart disease patients with high heart rate associated with single VPBs and improve coronary artery image quality.