摘要
目的:研究冠状动脉CT血管造影(CCTA)轴位扫描和螺旋扫描中影像质量与辐射剂量的关系。方法:回顾性选取2021年7月至2022年1月在首都医科大学附属北京友谊医院行CCTA检查的60例患者,按扫描模式不同将其分为轴位扫描组和螺旋扫描组,每组30例。分析两种扫描模式的影像质量、辐射剂量、检查过程平均心率、对中度及以上冠状动脉狭窄(狭窄程度≥50%)的诊断价值及患者满意度。结果:轴位扫描组和螺旋扫描组患者的CCTA影像质量优良率分别为96.67%(29/30)、93.33%(28/30),差异无统计学意义(P>0.05)。轴位扫描组剂量-长度乘积(DLP)、容积CT剂量指数(CTDIvol)、有效剂量(ED)均低于螺旋扫描组,差异有统计学意义(t=180.637、30.945、368.414,P<0.05);两组患者检查过程中的平均心率、不同心率下DLP、ED比较差异均无统计学意义(P>0.05)。以数字减影血管造影检查为“金标准”,轴位扫描组诊断灵敏度、特异度、准确率、阳性预测值和阴性预测值均高于螺旋扫描组,差异有统计学意义(χ^(2)=11.140、12.830、13.340、9.350、14.450,P<0.05)。轴位扫描组患者CCTA影像检查模式的患者扫描过程体验满意度为93.33%(28/30)高于螺旋扫描组,差异有统计学意义(χ^(2)=5.455,P<0.05)。结论:CCTA轴位扫描影像质量的客观评价、诊断价值、患者满意度高于螺旋扫描模式,辐射剂量低于螺旋扫描模式。CCTA需依据患者心率及冠状动脉狭窄程度等实际情况选用合理的扫描模式。
Objective:To investigate the relationship between image quality and radiation dose in axial scan and spiral scan of coronary computed tomography angiography(CCTA).Methods:A total of 60 patients who underwent CCTA in Beijing Friendship Hospital of Capital Medical University from July 2021 to January 2022 were selected,and they were divided into an axial scan group and a spiral scan group,with 30 cases in each group.The image quality,radiation dose,average heart rate during the examination,diagnostic value for moderate and severe coronary stenosis(degree≥50%)and patients’satisfaction of two kinds of modes were analyzed.Results:The excellent rates of image quality of axial scan group and spiral scan group were respectively 96.67%(29/30)and 93.33%(28/30),without significant differences(P>0.05).The dose-length product(DLP),computed tomography dose index of volume(CTDIvol)and effective dose(ED)in the axial scan group were significantly lower than those in the spiral scan group(t=180.637,30.945,368.414,P<0.05),respectively.There were no statistically significant differences in the average heart rate,DLP and ED under different heart rate between the two groups during the examination process(P>0.05).The examination of digital subtraction angiography was used as“gold standard”,and the diagnostic sensitivity,specificity,accuracy,positively predictive value and negatively predictive value in the axial scan group were significantly higher than those in the spiral scan group(χ^(2)=11.140,12.830,13.340,9.350,14.450,P<0.05),respectively.The satisfaction degree of service effect of patients in axial scan group was 93.33%(28/30)for examination mode of CCTA imaging,which was significantly higher than that of spiral scan group,and the difference was significant(χ^(2)=5.455,P<0.05).Conclusion:The objective assessment,diagnostic value and patient's satisfaction of image quality of axial scan of CCTA are higher than those of spiral scan mode,which radiation dose is lower than that of spiral scan mode.CCTA should choose reasonable scan mode according to heart rate and degree of coronary artery stenosis,and other,actual condition of patients.
作者
李向明
孔亚群
王新明
张立新
Li Xiangming;Kong Yaqun;Wang Xinming;Zhang Lixin(Department of Radiology,Beijing Friendship Hospital of Capital Medical University,Beijing 101100,China;Department of Stomatology,Beijing Friendship Hospital of Capital Medical University,Beijing 101100,China;Beijing Beite Borui Technology Testing Co.,Ltd.,Beijing 100000,China)
出处
《中国医学装备》
2024年第12期13-17,共5页
China Medical Equipment
基金
国家自然科学基金(82272068)。
作者简介
通信作者:张立新,Email:zhanglixin999999@sina.com。
