【摘要】 目的 评价128排双源CT Flash Spiral(FS)扫描模式在冠状动脉成像中的应用价值。方法 248例胸痛、胸闷且心率<65次min的患者行冠状动脉CTA检查,其中68例检查前服用β-受体阻滞剂控制心率。根据患者身高体重指数(body mass index,BMI)大小不同(BMI<19、19≤BMI≤25、BMI>25)分别采用3种(80 kV、100 kV、120 kV)不同的管电压进行前瞻性心电门控技术触发的FS模式扫描,数据采集开始于60%时相并在1个心动周期内完成。图像质量根据4级分法(1:优秀～4:不能诊断)评价标准,由2位高年资医师以双盲法单独对所有的冠状动脉段图像进行评价。结果 248例均扫描成功,Z轴扫描范围为(118±8) mm,扫描时间为(259±19) ms。根据BMI不同采用3种不同管电压扫描,获得可诊断影像比率分别为99.3%、99.4%、99.6%,其辐射剂量分别为(0.36±0.02) mSv、(0.92±0.06) mSv、(1.52±0.13) mSv,辐射剂量3者间存在显著差异,具有统计学意义(P<0.01)。结论 128排双源CT的FS模式是真正实现1个心动周期完成扫描且辐射剂量超低的理想方法。根据BMI大小不同采用不同的管电压,能显著降低BMI较低患者的辐射剂量。更多还原

【Abstract】 Objective To evaluate the application of 128-slice dual-source CT flash spiral(FS) pattern in coronary computed tomography angiography(CTA).Methods 248 cases with chest pain and chest tightness and sinus rhythm <65 beats/min underwent CTA using FS model at 128-slice dual-source CT scanner,of whom 68 cases taking β-blocker to control heart rate before coronary CTA.According to the body mass index(BMI,BMI<19,19≤BMI≤25 and BMI>25) of the patients,3 different tube voltages(80 kV,100 Kv and 120 kV) for FS pattern scan were applied respectively,and the acquisition of data was prospectively triggered at60% of the R-R interval and completed in one cardiac cycle.All coronary segments were evaluated by two independent observers blindly with regard to image quality on a four-scale(1:excellent to 4:non-diagnostic).Results CT scanning was successful in all 248patients.The mean length of the Z-axis scanning was(118±8) mm and the mean duration of datum acquisition was(259±19) ms.According to BMI,the diagnostic rates of image quality at scanning using 3 different tube voltages were 99.3%,99.4% and 99.6%,respectively,and coronary CTA radiation doses were(0.36±0.02) mSv,(0.92±0.06) mSv and(1.52±0.13) mSv,respectively,the radiation dose between them were statistically significant(P<0.01).Conclusion The coronary CTA FS model is truly a cardiac cycle to complete the scan and is a ideal way to decrease radiation doses.According to BMI using different tube voltages,can significantly reduce the radiation dose in patients with lower BMI.更多还原