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目的评价高心率条件下前瞻性心电门控技术结合运动校正算法(SSF)进行低剂量冠状动脉CT血管成像(CCTA)的可行性。方法连续搜集行CCTA检查的疑似冠心病的高心率患者60例,随机选择30例采用回顾性心电门控技术(RGH)扫描,另外30例采用前瞻性心电门控技术(SAS)扫描。RGH组选择冠状动脉显示最佳的时相,行SSF算法重组;SAS组使用SSF算法重组的目标时相选择50%R-R间期。比较RGH组和SAS组内标准算法重组(STD)和SSF算法重组之间的图像质量评分、可诊断率和优良率,以及两组SSF算法重建之间的有效剂量、图像质量评分、可诊断率和优良率。结果 RGH组和SAS组内SSF算法和STD算法重组之间的图像质量评分、可诊断率及优良率的差异均有统计学意义(P=0.000);SAS组的有效剂量为(3.3±1.3)mSv,RGH组的有效剂量为(9.2±1.5)mSv。SAS组和RGH组之间SSF算法重组的图像质量评分、可诊断率以及优良率的差异无统计学意义(P>0.05)。结论在高心率条件下,前瞻性心电门控技术结合SSF算法可以取代回顾性心电门控技术进行CCTA,在降低辐射剂量的同时不损害图像质量。
Objective To evaluate the feasibility of low-dose coronary artery CT angiography (CCTA) using prospective ECG-gating combined with motion-corrected algorithm (SSF) under high heart rate. Methods Sixty consecutive patients with high heart rate suspected coronary heart disease undergoing CCTA were enrolled in the study. Thirty patients were randomly selected retrospectively by RGH scan, and the other 30 patients were prospectively scored by SAS. In the RGH group, the coronary arteries showed the best time phase, and the SSF algorithm was used for recombination. In the SAS group, the 50% R-R interval was selected for the target phase of SSF recombination. Comparing the image quality score, the diagnostic rate and the good rate between the standard algorithm recombination (STD) and the SSF algorithm recombination in the RGH group and the SAS group, and the effective dose, the image quality score and the diagnostability between the two groups of SSF algorithm reconstruction And excellent rate. Results There was a significant difference in the diagnostic accuracy and the excellent and good rates between the SSF algorithm and the STD algorithm in RGH group and SAS group (P = 0.000). The effective dose in SAS group was (3.3 ± 1.3) The effective dose of mSv and RGH group was (9.2 ± 1.5) mSv. There was no significant difference in the image quality score, the diagnostic rate and the excellent and good rate of SSF algorithm between SAS group and RGH group (P> 0.05). Conclusions Under the condition of high heart rate, prospective ECG-gating combined with SSF algorithm can replace retrospective ECG-gated technique for CCTA, which can reduce the radiation dose without damaging the image quality.