双低剂量技术结合CTA与超声心动图在急性冠脉综合征患者诊断中的应用
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摘要
目的探讨双低剂量CT血管造影(CTA)与超声心动图(UCG)对急性冠脉综合征(ACS)的诊断效果。方法回顾性分析124例ACS患者临床资料,根据"金标准"冠状动脉造影(CAG)检查结果分为单支病变组(n=23)、双支病变组(n=45)、多支病变组(n=56),比较三组双低剂量CTA下病变程度(Gensini积分)、左室射血分数(LVEF)、左室舒张末期内径(LVEDd)差别,分析单纯双低剂量CTA、双低剂量CTA联合UCG及常规CTA分级诊断ACS的准确性差异。结果双低剂量CTA下Gensini积分、LVEDd水平比较单支病变组<双支病变组<多支病变组,LVEF水平比较单支病变组>双支病变组>多支病变组,差异均有统计学意义(P<0.05)。双低剂量CTA联合UCG及常规CTA分级诊断ACS准确率比较无统计学意义(P>0.05),但均明显高于单纯双低剂量CTA,差异有统计学意义(P<0.05)。结论双低剂量CTA与UCG应用于分级诊断ACS效果较为理想,准确率与常规CTA相仿,减少辐射与造影剂负荷剂量对优化患者诊疗体验有利。
Objective To explore the diagnostic effects of double low dose CT angiography(CTA) and ultrasonic cardiogram(UCG) on acute coronary syndrome(ACS). Methods The clinical data of 124 patients with ACS were retrospectively analyzed. According to the "gold standard" coronary angiography(CAG) test results were divided into single-vessel disease group(n=23), double-vessel disease group(n=45) and multi-vessel disease group(n=56). The lesions degree(Gensini score), left ventricular ejection fraction(LVEF) and left ventricular end-diastolic diameter(LVEDd) double low dose CTA were compared among the three groups, and the accuracies of simple double low dose CTA, double low dose CTA combined UCG and conventional CTA grades were analyzed in the diagnosis of ACS. Results Gensini score and LVEDd level under double low dose CTA showed single-vessel disease groupdouble-vessel disease group>multi-vessel disease group(P<0.05). There was no statistically significant difference in the accuracy between double low dose CTA combined with UCG and conventional CTA grades in the diagnosis of ACS(P>0.05), but it was significantly higher than that of single double low dose CTA(P<0.05). Conclusion Double low dose CTA and UCG is ideal for the grading diagnosis of ACS, and its accuracy is similar to that of conventional CTA. And it is beneficial to optimize the patients' diagnosis and treatment experience by reducing radiation and contrast agent loading dose.
Objective To explore the diagnostic effects of double low dose CT angiography(CTA) and ultrasonic cardiogram(UCG) on acute coronary syndrome(ACS). Methods The clinical data of 124 patients with ACS were retrospectively analyzed. According to the "gold standard" coronary angiography(CAG) test results were divided into single-vessel disease group(n=23), double-vessel disease group(n=45) and multi-vessel disease group(n=56). The lesions degree(Gensini score), left ventricular ejection fraction(LVEF) and left ventricular end-diastolic diameter(LVEDd) double low dose CTA were compared among the three groups, and the accuracies of simple double low dose CTA, double low dose CTA combined UCG and conventional CTA grades were analyzed in the diagnosis of ACS. Results Gensini score and LVEDd level under double low dose CTA showed single-vessel disease group
引文
[1]梁奕,孔祥泉,杜柏林.“双低”技术在冠状动脉CT血管成像中的应用进展[J].实用放射学杂志,2015,31(7):1208-1211.
[2]中国医师协会急诊医师分会.急性冠脉综合征急诊快速诊疗指南[J].中华急诊医学杂志,2016,36(4):207-214.
[3]Neeland I J,Patel R S,Eshtehardi P,et a l.Coronary angiographic scoring sys tems:An evaluat ion of their equivalence and validi ty[J].American Heart Journal,2012,164(4):547-552.
[4]别艾军.急性冠脉综合征患者NT-proBNP与冠脉病变程度及心功能的关系[J].中华全科医学,2013,11(6):877-879.
[5]郑昊钏,龙芳,杨华,等.急性冠脉综合征的发病机制及治疗进展[J].中国药房,2014,25(30):2846-2848.
[6]牛学明,王付启,张芳,等.冠心病患者Gensini评分及左心功能参数的64排CT评价[J].中国CT和MRI杂志,2016,14(4):45-48.
[7]刘卓,张诚,陈尘,等.高时间分辨率宽体探测器CT对心房颤动患者冠状动脉造影可行性研究[J].临床放射学杂志,2016,35(5):786-789.
[8]陈刚,吴东,曾蒙苏,等.双源CT冠状动脉成像辐射剂量的优化[J].放射学实践,2014,29(06):593-596.
[9]张园,陆欣.冠状动脉介入治疗并发造影剂肾病的危险因素分析[J].医学临床研究,2016,33(5):969-971.
[1 0]舒礼良,黄功成,张永高,等.CTA联合自适应统计迭代重建技术在冠状动脉病变患者中的应用[J].中国CT和MRI杂志,2 017,15(12):31-33,68.
[11]陈伟彬,冯莉,张伟杰,等.优化对比剂注射方案对冠状动脉CT A图像的影响[J].临床放射学杂志,2017,36(1 1):1712-1715.
[12]方玉荣,娄明武.双低剂量CT冠状动脉成像的研究进展[J].实用放射学杂志,2015,31(8):1 377-1381.
[2]中国医师协会急诊医师分会.急性冠脉综合征急诊快速诊疗指南[J].中华急诊医学杂志,2016,36(4):207-214.
[3]Neeland I J,Patel R S,Eshtehardi P,et a l.Coronary angiographic scoring sys tems:An evaluat ion of their equivalence and validi ty[J].American Heart Journal,2012,164(4):547-552.
[4]别艾军.急性冠脉综合征患者NT-proBNP与冠脉病变程度及心功能的关系[J].中华全科医学,2013,11(6):877-879.
[5]郑昊钏,龙芳,杨华,等.急性冠脉综合征的发病机制及治疗进展[J].中国药房,2014,25(30):2846-2848.
[6]牛学明,王付启,张芳,等.冠心病患者Gensini评分及左心功能参数的64排CT评价[J].中国CT和MRI杂志,2016,14(4):45-48.
[7]刘卓,张诚,陈尘,等.高时间分辨率宽体探测器CT对心房颤动患者冠状动脉造影可行性研究[J].临床放射学杂志,2016,35(5):786-789.
[8]陈刚,吴东,曾蒙苏,等.双源CT冠状动脉成像辐射剂量的优化[J].放射学实践,2014,29(06):593-596.
[9]张园,陆欣.冠状动脉介入治疗并发造影剂肾病的危险因素分析[J].医学临床研究,2016,33(5):969-971.
[1 0]舒礼良,黄功成,张永高,等.CTA联合自适应统计迭代重建技术在冠状动脉病变患者中的应用[J].中国CT和MRI杂志,2 017,15(12):31-33,68.
[11]陈伟彬,冯莉,张伟杰,等.优化对比剂注射方案对冠状动脉CT A图像的影响[J].临床放射学杂志,2017,36(1 1):1712-1715.
[12]方玉荣,娄明武.双低剂量CT冠状动脉成像的研究进展[J].实用放射学杂志,2015,31(8):1 377-1381.