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多层螺旋CT冠状动脉成像技术与三维重建

Image quality’s optimization of noninvasive coronary angiography using multislice spiral computed tomography

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【作者】 郑敏文石明国宦怡葛雅丽杨勇赵洪亮张劲松常英娟

【Author】 ZHENG Min - wen, SHI Ming-guo,HUAN Yi, GE Ya - li, YANG Yong, ZHAO Hong- Hang, ZHANGJing- song, CHANG Ying-juan

【机构】 西安市第四军医大学附属西京医院放射科

【摘要】 目的:探讨16层螺旋CT冠状动脉成像的扫描技术、重建时相及三维重建方法优选。材料和方法:经16层螺旋CT冠状动脉血管造影的20例心率>70次/min的患者,扫描层厚0.5-1mm,重建层厚0.3-0.5mm。时比剂100-150ml(100ml时加生理盐水30ml),流率3.5ml/s。回顾性心电门控,原始数据用segmen(?)法重建,分别在上一个R波后40%-80%5个时相重建。三维重建方法分别为最大密度投影(MIP)、容积再现(VR)、多平面重组(MPR)和曲面重建(CPR)。结果:扫描时使用100ml对比剂加30ml生理盐水的成像效果优于150ml对比剂;采用surestart延迟扫描技术时主动脉根部CT值升至180Hu时扫描优于140Hu;5个重建时相中,右冠最佳显示时相为40%、80%,回旋支为70%,前降支各时相均可。50%和60%时相冠状动脉各支均显示欠佳,故常规只需重建40%、70%和80%三个时相即可。三维重建方法中以MIP、MPR和CPR血管探针技术最具诊断价值。VR则具立体观察优势。结论:扫描技术、重建时相及三维重建方法的优选将极大地提高多层螺旋CT冠状动脉成像的质量。

【Abstract】 Purpose: To investigate the optimized coronary artery image quality of noninvasive coronary angiography using multislice spiral computed tomography. Materials and Methods: The data sets of 20 patients (with HR > 70 bpm) were analyzed. The patients underwent multislice spiral CT(Aquilion 16, Toshiba, Japan) using the following parameters: 0.5-1mm slice thickness, 0.3-0.5mm reconstruction thickness, 120 kV, 500 mA, pitch of 0.25. Images were generated by multisegmental reconstruction from 40% to 80% cardial R - R interval. The three - dimentional reconstruction methods were maximum intensity projection (MIP), multiple planar reformat (MPR), curved planar reformat (CPR) and volume rendering (VR) . Results: Intravenous administration of 100 ml of iodinated contrast material followed by 30 ml saline bolus chaser is better than 150 ml of iodinated contrast material,In 5 reconstruction phases, right coronary artery showed best in the phase of 40% and 80% and the left circumflex of 70% and 80% . The left main coronary artery and anterior descending coronary atery were clear showing in every phases.So, we just need to reconstruct three phases of 40% , 70% and 80% in conventional work. In all three- dimension reconstruction methods, MEP, MPR and CPR have diagnostic values, VR has three dimension visualized advantages. Conclusion: Optimization of scanning skills, reconstruction phases and three dimension reconstruction methods chosing are greatly improve coronary artery image quality of multislice spiral CT.

【关键词】 冠状动脉血管造影术CT
【Key words】 coronary angiographystenosisCT
  • 【会议录名称】 中国人民解放军医学会第九届放射诊疗专业学会论文集
  • 【会议时间】2005
  • 【分类号】R816.2
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