中国医学科学院学报2017，Vol.39Issue(1)：34-41,8.DOI:10.3881/j.issn.1000-503X.2017.01.007
第3代双源CT低剂量心脏一站式成像的可行性
Application of the Low-dose One-stop-shop Cardiac CT Protocol with Third-generation Dual-source CT
摘要
Abstract
Objective To evaluate the feasibility of a low-dose one-stop-shop cardiac CT imaging protocol with third-generation dual-source CT (DSCT).Methods Totally 23 coronary artery disease (CAD) patients were prospectively enrolled between March to September in 2016.All patients underwent an ATP stress dynamic myocardial perfusion imaging (MPI) (data acquired prospectively ECG-triggered during end systole by table shuttle mode in 32 seconds) at 70 kV combined with prospectively ECG-triggered high-pitch coronary artery angiography (CCTA) on a third-generation DSCT system.Myocardial blood flow (MBF) was quantified and compared between perfusion normal and abnormal myocardial segments based on AHA-17-segment model.CCTA images were evaluated qualitatively based on SCCT-18-segment model and the effective dose (ED) was calculated.In patients with subsequent catheter coronary angiography (CCA) as reference, the diagnosis performance of MPI (for per-vessel ≥50％ and ≥70％ stenosis) and CCTA (for≥50％ stenosis) were assessed.Results Of 23 patients who had completed the examination of ATP stress MPI plus CCTA, 12 patients received follow-up CCA.At ATP stress MPI, 77 segments (19.7％) in 13 patients (56.5％) had perfusion abnormalities.The MBF values of hypo-perfused myocardial segments decreased significantly compared with normal segments [(93 ± 22) ml/(100ml·min) vs.(147±27) ml/(100 ml· min);t=15.978, P=0.000].At CCTA, 93.9％ (308/328) of the coronary segments had diagnostic image quality.With CCA as the reference standard, the per-vessel and per-segment sensitivity, specificity, and accuracy of CCTA for stenosis≥50％ were 94.1％, 93.5％, and 93.7％ and 90.9％, 97.8％, and 96.8％, and the per-vessel sensitivity, specificity and accuracy of ATP stressMPI for stenosis≥50％ and ≥70％ were 68.7％, 100％, and 89.5％ and 91.7％, 100％, and 97.9％.The total ED of MPI and CCTA was (3.9±1.3) mSv [MPI:(3.5±1.2) mSv, CCTA:(0.3± 0.1) mSv].Conclusion The third-generation DSCT stress dynamic MPI at 70 kV combined with prospectively ECG-triggered high-pitch CCTA is a feasible and reliable tool for clinical diagnosis, with remarkably reduced radiation dose.关键词
冠心病/ATP负荷CT动态心肌灌注成像/冠状动脉CT血管成像/第3代双源CT/辐射剂量Key words
coronary artery disease/ATP stress CT dynamic myocardial perfusion imaging/coronary CT angiography/third-generation dual-source CT/radiation dose分类
医药卫生引用本文复制引用
林路,金征宇,王怡宁,易妍,曹剑,孔令燕,钱浩,张洪芝,吴炜,王沄..第3代双源CT低剂量心脏一站式成像的可行性[J].中国医学科学院学报,2017,39(1):34-41,8.基金项目
国家自然科学基金(81471725)、北京市自然科学基金(7142133)和卫生公益性行业科研专项项目(201402019、 201402001) Supported by the National Natural Sciences Foundation of China (81471725),the Beijing Municipal Natural Science Foundation (7142133),and the Health Industry Special Scientific Research Project (201402019,201402001) （81471725）
