【摘要】 目的:评估追踪冻结技术在高心率儿童冠状动脉CT血管成像中的应用价值。材料与方法:37例拟诊为川崎病或冠状动脉起源发育异常且心率高于80次/min的患儿(年龄(6.9±4.1)岁,心率(88.5±7.2)次/min),行冠状动脉CT血管造影检查。扫描原始数据使用智能期相选择技术,选取血管显示较好的一组期相进行两组重建。一组使用标准算法重建,另一组使用追踪冻结(SSF)算法重建。图像质量以及可解读性由两位有经验的医师应用冠状动脉18分段法对每支冠状动脉和节段血管进行评分。评分采用4分制。图像评分≥2分为可解读。结果:在图像主观评分中,SSF算法组与STD组右冠状动脉((3.43±0.67)分和(3.07±0.67)分,P<0.001)评分存在统计学差异(P<0.05);左冠状动脉主干((3.85±0.33)分和(3.84±0.33)分,P=1.00)评分无统计学差异(P>0.05);前降支((2.90±0.54)分和(2.68±0.58)分,P=0.002)和回旋支((2.76±0.56)分和(2.58±0.57)分,P=0.009)评分均存在统计学差异(P<0.05);患儿分支血管、节段以及患者整体水平的SSF组图像评分均高于STD组。在图像可解读性中,SSF组与STD组分支血管(98%,93%)与节段血管(92%,90%)可解读率提高。患者整体图像可解读率两组间没有统计学差异(P>0.05)。入组患儿所受有效辐射剂量为(2.1±1.3)mSv。结论:在高心率儿童冠状动脉CTA扫描重建方案中,配合使用追踪冻结技术可以降低血管周围伪影,提高血管影像质量,为冠状动脉的显示以及疾病的诊断提供有效的帮助。更多还原

【Abstract】 Objective: To evaluate the feasibility of the motion correction algorithm snapshot-freeze(SSF) in high heart rate pediatric patients. Methods: Thirty-seven pediatric patients((6.9±4.1) years) with Kawasaki disease or abnormal coronary origin and heart rate(HR) more than 80 beats/min((88.5±7.2) beats/min) undergoing CCTA were enrolled. The CCTA scan data were reconstructed using the smart phase(SP) to select the optimal phase. All images were reconstructed using standard(STD) algo-rithm and a motion-correction algorithm SSF technique. The image quality of coronary artery segments was scored with Liken4-points score system by two radiologists using the American College of Cardiology recommended coronary artery 18-segmen-tation method. The image qualities and interpretability were assessed on per-artery, per-segment level and per-patient levels.Image score≥2 is considered to be interpretable. Results: Image qualities score were higher with the use of SSF than STD reconstructions on RAD((3.43 ±0.67) vs(3.07 ±0.67), P <0.001), LM((3.85 ±0.33) vs(3.84 ±0.33), P =1.00), LAD((2.90 ±0.54) vs(2.68±0.58), P=0.002), LCX((2.76±0.56) vs(2.58±0.57), P=0.009). There was a significant difference in image quality between SSF and STD on per-artery level((3.23 ±0.69) vs(3.12±0.71), P<0.001), and per-segment level((2.97 ±0.93) vs(2.84±0.93), P<0.001), and per-patient level((2.96±0.45) vs(2.83±0.45), P<0.001). SSF reconstructions showed higher interpretability than STD reconstructions on diagnostic performance on per-artery level(0.98 vs 0.93, P=0.013), and per-segment level(0.92 vs 0.90, P=0.008). There was no significant difference between two groups in interpretability on per-patient level(0.97 vs 0.92, P=0.25).The mean effective dose was(2.1±1.3) mSv. Conclusion: The use of SSF technique reconstruction in high heart rate pediatric patients can reduce motion artifacts and improves image quality undergoing CCTA.更多还原