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目的初步探讨无需口服控制心率药物准备的双源 CT 冠状动脉成像的扫描技术和图像质量。方法对215例临床怀疑冠心病或冠状动脉早期病变患者进行无需口服控制心率药物准备的双源 CT 冠状动脉成像。扫描步骤包括平扫和增强扫描。用平扫图像行冠状动脉钙化积分,用增强扫描图像行多平面重组(MPR)、最大密度投影(MIP)及容积再现技术(VRT)重组。总结双源 CT冠状动脉成像的扫描技术和后处理方法。将图像质量分为3级,按冠状动脉分段标准评价各个节段的图像质量。结果 215例患者钙化积分值中位数为82.2(2.3～1827.9)。增强扫描平均心率为(80.6±15.3)(57～139)次/min,尽可能使冠状动脉良好显示的后处理方法有:(1)多个时相筛选法;(2)2个或多个时相补充法;(3)早搏去除法和心律不齐移位法。共评价3026个冠状动脉节段,其中图像质量为1级者占97.5%(2951/3026),2级者占2.0%(62/3026),为3级者占0.5%(13/3026);图像质量为2级和3级的节段多由于呼吸伪影所致。215例患者共91例冠状动脉各节段均未见斑块或狭窄,共诊断<50%冠状动脉狭窄节段112个,≥50%冠状动脉狭窄节段213个。结论双源 CT 冠状动脉成像在无需口服控制心率药物准备的情况下可获得非常好的冠状动脉各节段图像,心率不再是影响图像质量的关键因素,通过单时相或多时相重组可良好显示冠状动脉主干及分支。
Objective To explore the scanning technique and image quality of double-source CT coronary angiography without oral preparation for heart rate control. Methods A total of 215 patients with clinically suspected coronary heart disease or early coronary artery disease underwent double-source CT coronary angiography without oral medication control. Scanning steps include plain scan and enhanced scan. Coronary calcification scores were scored using plain scan images, and the images were reconstructed using enhanced scan images with multiplanar reconstruction (MPR), maximum density projection (MIP), and volume rendering techniques (VRT). Summary dual-source CT coronary angiography scanning technology and post-processing methods. The image quality is divided into three levels, according to coronary artery segmentation criteria to evaluate the image quality of each segment. Results The median calcification score of 215 patients was 82.2 (2.3 ~ 1827.9). (80.6 ± 15.3) (57- 139) beats / min for enhanced scan, the best postprocessing method for coronary arteries was as follows: (1) multiple phase selection methods; (2) two or more Phase complementary method; (3) premature beat removal and arrhythmia shift method. A total of 3026 coronary arteries were evaluated, including 97.5% (2951/3026) with image quality level 1, 2.0% (62/3026) with grade 2, and 0.5% (13/3026) with grade 3. Segments of image quality levels 2 and 3 are mostly due to respiratory artifacts. A total of 91 cases of 215 patients with coronary artery segments were no plaques or stenosis, a total of 112 cases were diagnosed <50% coronary stenosis segment, ≥ 50% coronary stenosis segment 213. Conclusion Dual-source CT coronary angiography can obtain very good images of coronary arteries without the need for oral controlled heart rate drug preparations. Heart rate is no longer a key factor affecting image quality and may be good by single-time or multiple-phase recombination Shows the main coronary artery and branches.