320排CT冠状动脉成像图像质量、诊断结果、辐射剂量研究.docVIP

320排CT冠状动脉成像图像质量、诊断结果、辐射剂量研究[摘要]目的 评价320排CT冠状动脉成像的图像质量、诊断真实性及辐射剂量。方法 选取我院64例采用前瞻性心电门控技术行320排容积CT冠状动脉成像的患者，以传统冠状动脉成像作为金标准，在VR、MPR、CPR重建的基础上分析冠状动脉图像质量和诊断冠状动脉狭窄≥50%的敏感性、特异性、阳性预测值、阴性预测值、正确诊断指数，同时比较两项检查患者接受的辐射剂量。结果 64例患者共评价冠状动脉836个血管段，优良率为90.6%，可评价比例99.9%；对诊断冠状动脉狭窄≥50%的敏感性、特异性、阴性预测值、阳性预测值、正确诊断指数分别为80.5%、98.1%、97.4%、85.0%、78.6%；CTCA组和CAG组的平均有效辐射剂量分别为（11.5±8.10）mSv、（4.03±3.35）mSv，两者间差异有统计学意义（t=6.18，P=0.000）。结论 320排CT冠状动脉成像诊断明显冠状动脉狭窄具有较高的准确率，应该作为冠状动脉疾病筛查和复查的首选。 [关键词] 冠状动脉疾病；体层摄影术；计算机摄影术；冠状血管造影术 [中图分类号] R543.3 [文献标识码] B [文章编号] 1673-9701（2011）22-106-03 The Study of Image Quality，Diagnostic Performance and Radiation Dose in CT Computed Tomography Angiography Using 320-detector Scanner ZENG Yunjian XU Jian ZHAO Chao DI Xingbo Department of Radiology，Zhejiang Provincial Peoples Hospital，Hangzhou 310014，China [Abstract] Objective To evaluate image quality，diagnostic performance and radiation dose obtained with 320-detector CT scanner.Methods All 64 patients underwent CT angiography using 320-detector CT scanner and Conventional artery angiography（CAG）.CAG served as the gold reference.Data settings were evaluated based on 4-point scale through VR、MPR、CPR.The sensitivity，specificity，negative predictive value（NPV），positive predictive value（PPV） and Youden index were calculated to detector significant stenosis（≥50% lumen diameter reduction）.Radiation dose of CTCA and CAG were matched to study. Results 836 coronary artery segments were explored.The rate of excellent and good image quality and rate of assessable segments was 90.6%，99.9% respectively；sensitivity，specificity，NPV，PPV was 80.5%，98.1%，97.4%，85.0% respectively；Radiation dose of CTCA and CAG was on average （11.5±8.10）mSv，（4.03±3.35）mSv，a statistic difference was found between them（t=6.18，P=0.000）. Conclusion CTCA with excellent diagnostic reality using 320-detector CT scanner should be taken as the first chose to screen CAD and reexamine after operation. [Key words] Coronary disease；Tomography；X-ray compu