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目的:研究不同心率状态下双源CT的冠状动脉成像质量情况及收缩期和舒张期成像质量的差异。方法:345例受试者,男248例,女97例,年龄24~86岁,心率49~133次/分,平均心率74.2±14.4次/分(均未给予药物控制心率),行双源CT冠状动脉CTA扫描,在后处理工作站进行三维重组后,由两名有经验的放射医师对所有受检对象的冠状动脉成像质量进行分段评分(1分~5分)。按受检时心率分为5组,分别统计各组冠状动脉各段的成像质量评分,收缩期和舒张期最佳时相的成像质量评分,以及最佳时相在R-R间期的分布情况。结果:成像成功率为99.9%(3392/3395)。图像质量评分总均值为(4.76±0.57),评分均值与心率呈负相关(r=-0.973,P=0.005)。当心率增高时,收缩期的成像质量和舒张期的成像质量均有下降的趋势,但收缩期下降幅度与舒张期比较明显较缓。当心率<80次/分时,最佳时相多数在舒张期得到,占79.6%(183/230),特别集中于R-R间期的70%左右,占68.3%(157/230),有88.7%(306/345)的受检对象在收缩期和舒张期两期都能得到优良(4分以上)的图像;当心率≥80次/分时,最佳时相多数在收缩期得到,占83.5%(96/115),仅有10.4%(12/345)的受检对象在收缩期和舒张期两期都能得到优良的图像。结论:在排除了心律不齐影响因素的情况下,双源CT在患者处于自然心率状态下其冠状动脉成像成功率接近100%;但心率对冠状动脉成像质量仍有一定影响;当心率<80次/分时大多数可以在收缩期和舒张期双期成像,而心率≥80次/分时一般只能在收缩期成像。
Objective: To study the coronary angiography quality and systolic and diastolic imaging quality of dual-source CT under different heart rate. Methods: A total of 345 subjects including 248 males and 97 females, aged from 24 to 86 years with a heart rate of 49 to 133 beats / min and an average heart rate of 74.2 ± 14.4 beats / min (no drug control heart rate) CT Coronary CTA scans and three-dimensional reconstructions at the post-treatment workstation were performed by two experienced radiologists to segment the coronary arteries of all subjects (1 point to 5 points). The heart rate was divided into five groups according to the heart rate. The imaging quality scores of each segment of coronary artery, the imaging quality score of the systolic and diastolic optimal phases, and the distribution of the best phase in the R-R interval were calculated. Results: The imaging success rate was 99.9% (3392/3395). The mean image quality score was (4.76 ± 0.57), and the mean score was negatively correlated with heart rate (r = -0.973, P = 0.005). When the heart rate increased, the imaging quality of systolic phase and the imaging quality of diastolic phase tended to decrease, but the decrease of systolic phase was more obvious than that of diastolic phase. When the heart rate was <80 beats / min, the best of the best phases were obtained at diastole, accounting for 79.6% (183/230), especially about 70% of the RR interval, accounting for 68.3% (157/230) with 88.7 % (306/345) of the subjects in both systole and diastole can get good (4 points or more) images; when the heart rate ≥ 80 beats / min, the best phase most of the time in the systolic phase, accounting for 83.5% (96/115), and only 10.4% (12/345) of subjects had excellent images in both systole and diastolic phases. Conclusion: In the circumstance of excluding arrhythmia, the success rate of dual-source CT imaging in coronary artery imaging is close to 100% when the patients are in natural heart rate. However, the heart rate still has some influence on the quality of coronary artery imaging. When the heart rate is less than 80 Most times / min can be systolic and diastolic two-phase imaging, and heart rate ≥ 80 beats / min generally only in systolic imaging.