心率波动对16层CT冠脉成像图像质量的影响及对策(心脏体模模拟实验)

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目的研究心率波动对16层螺旋CT冠状动脉成像质量的影响及心率波动情况下最佳扫描条件。方法采用GELight-Speed16层螺旋CT,以心脏冠脉扫描模式对心脏体模进行扫描。心率设置为以60次/min、85次/min为中心上下波动2组,每组分别设置波幅为2.5次/min、5次/min和10次/min各3小组,分别对6组心率波动情况下的心脏体模以心脏冠脉扫描模式进行扫描,所有扫描数据在R-R间期5%、15%、25%、35%、45%、55%、65%、75%、85%、95%相位分别进行单扇区(Segment)、双扇区(Burst-2)和四扇区重建(Burst-4)。重建数据传至AW4.1工作站后处理成像。后处理方法采用容积再现(VR)、多平面重组(MPR)模式。由1名高年资医师和1名技师分别对不同重组图像进行评分。统计学处理采用析因分析。结果(1)方差分析显示,总模型具有显著意义(F=22.58,P<0.0001),各变量(心率、波幅、算法和相位)具有显著意义,均对冠状动脉成像质量有影响;(2)不同心率之间比较:心率为60次/min者图像质量评分均数显著高于心率为85次/min者(P<0.05);(3)不同波动范围之间比较:波幅为2.5次/min和5次/min者,图像质量评分均数高于波幅为10次/min者(P<0.05),但波幅为2.5次/min和5次/min无显著差异(P>0.05);(4)不同重建算法之间比较:算法为Burst-4和Burst-2者图像质量评分均数显著高于算法为Segment(P<0.05),但Burst-4和Burst-2之间无显著差异(P>0.05);(5)不同相位之间比较:相位为45%,95%显著高于其他相位(P<0.05),但上述二者相位之间无显著差异(P>0.05)。相位为15%者,图像质量最差。结论新型心脏动态体模评价心率波动对16层螺旋CT冠状动脉成像质量的影响及心率波动情况下最佳扫描条件分析,能够为临床应用和基础研究提供帮助。 Objective To study the influence of heart rate fluctuation on 16-slice spiral CT coronary angiography and the best scanning conditions under the condition of heart rate fluctuation. Methods GELight-Speed ​​16-slice spiral CT was used to scan the heart phantom in coronary heart scan mode. The heart rate was set to fluctuate 2 groups with 60 times / min and 85 times / min as the center, and each group was given 3 groups of amplitudes of 2.5 times / min, 5 times / min and 10 times / min respectively, The heart phantoms were scanned in a coronary heart scan mode and all scan data were analyzed at RR intervals of 5%, 15%, 25%, 35%, 45%, 55%, 65%, 75%, 85%, 95 % Segment, Burst-2 and Burst-4 respectively. Reconstruction data is transmitted to the AW4.1 workstation for post-processing imaging. Post-processing methods using volume reproduction (VR), multi-plane reorganization (MPR) mode. A senior physician and a technician scored different reorganized images respectively. Statistical analysis using factorial analysis. Results (1) ANOVA showed that the total model had significant significance (F = 22.58, P <0.0001). The variables (heart rate, amplitude, algorithm and phase) were significant and all affected the quality of coronary artery imaging. Comparison of different heart rates: mean heart rate of 60 beats / min were significantly higher than those with heart rate of 85 beats / min (P <0.05); (3) Comparison between different ranges: amplitude was 2.5 beats / min (P <0.05). However, the average image quality scores were higher than those with amplitude of 10 beats / min (P <0.05) Comparison between different reconstruction algorithms: The mean image quality scores for the Burst-4 and Burst-2 algorithms were significantly higher than those for the algorithm Segment (P <0.05), but there was no significant difference between Burst-4 and Burst-2 > 0.05). (5) The comparison of different phases: phase was 45%, 95% was significantly higher than other phases (P <0.05), but there was no significant difference between the two phases (P> 0.05). 15% of the phase, the worst image quality. Conclusions The impact of heart rate fluctuation on the quality of coronary artery imaging and the optimal scanning conditions under the condition of heart rate fluctuation can be evaluated by new cardiac dynamic phantom, which can be helpful for clinical application and basic research.
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