【摘要】 目的探讨心率-时间曲线在CT冠状动脉成像(CTCA)中的价值及临床应用。方法选取拟接受CTCA检查患者400例,分为A、B两组,每组200例。A组在扫描前5 s吸气屏气;B组根据训练时的心率-时间曲线,选取屏气后心率最佳时间进行扫描。心率在吸气屏气后随时间变化的规律分为下降型、平稳型、上升型及上升后下降型。统计并比较B组患者训练时和扫描时的曲线分布,A、B两组扫描时的心率波动和扫描开始时的心率;评价并比较A、B两组冠状动脉节段图像质量优良率。结果 B组训练时与扫描时比较,患者心率-时间曲线分布差异无统计学意义(χ2=0.751,P>0.05)。B组扫描时心率低于A组(t=3.523,P<0.01),心率波动小于A组(t=4.417,P<0.01)。A组冠状动脉节段图像质量优良率82.08%(2134/2600),B组为88.19%(2293/2600)(χ2=3.82,P<0.01)。结论利用训练时的心率-时间曲线可以优化扫描;利用心率-时间曲线可以在扫描时有效控制心率,减少心率波动,提高CTCA的成像质量。更多还原

【Abstract】 Objective To observe the value of heart rate-time curve in coronary CT angiography(CTCA) and its clinical applications.Methods Four hundred patients who would undergo CTCA were divided into 2 groups(group A and B,each n=200).In group A,scanning started at 5 s after breath-hold.In group B,scanning began at the best heart rate after breath-hold,based on heart rate-time curve during training.Heart rate variations with time after breath-hold were divided into 4 types: Decreased-type,stable-type,increased type,increased and then decreased type.The curves distribution of patients in training and scanning in group B were statistically analyzed and compared,as well as the heart rate and the heart rate fluctuations during scanning in group A and B.The imaging quality of CTCA in groups A and B were evaluated and compared.Results In group B,no statistical difference of the distribution of heart rate-time curves between training and scanning was found(χ2=0.751,P>0.05).Heart rates in group B were lower than that in group A(t=3.523,P<0.01).Heart rate fluctuations were significantly less in group B than in group A(t=4.417,P<0.01).For good and excellent rates of CTCA imaging quality,group A was 82.08%(2134/2600),group B was 88.19%(2293/2600)(χ2=3.82,P<0.01).Conclusion Heart rate-time curve in training could be used to optimize the scanning.The use of heart rate-time curve is effective in controlling heart rate during scanning,reducing the heart rate fluctuations and improving the imaging quality of CTCA.更多还原