心电编辑移除冠状动脉CTA冠状动脉水平段呼吸错层的应用
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摘要
目的探讨运用心电编辑功能移除冠状动脉CT血管造影(CCTA)冠状动脉水平段重度呼吸错层的临床应用价值。方法将12例CCTA冠状动脉水平段出现重度呼吸错层的病例纳入本研究。运用回顾性心电门控技术的心电编辑功能,冠状动脉起始水平段出现重度呼吸错层的病例,删除错层部位的前一个心动周期重组窗,使错层上移出现在冠状动脉水平段上方;右冠状动脉心底水平段出现重度错层的病例,删除错层部位后一个心动周期重组窗,使错层带下移出现在冠状动脉水平段下方。根据错层程度对心电编辑前后的图像评分并进行统计学处理(Wilcoxon检验,P<0.05为差异有统计学意义)。结果心电编辑前重度呼吸错层有5例出现在左冠状动脉起始水平段、6例出现在右冠状动脉起始水平段、1例出现在右冠心底水平段,全部12例均无法满足临床诊断需求。心电编辑后5例左冠状动脉起始水平段的呼吸错层上移出现在左冠状动脉起始水平段上方,左右冠状动脉的显示均不受影响;6例右冠状动脉起始水平段的呼吸错层上移有4例出现在左右冠状动脉水平段之间,右冠状动脉显示不受影响,左冠状动脉显示受到轻度影响但能满足临床诊断。2例右冠状动脉呼吸错层上移后又出现在左冠状动脉起始水平段上,采用心电编辑后的图像右冠状动脉显示良好,采用心电编辑前的图像左冠状动脉显示受到轻度影响但能满足临床诊断;1例右冠状动脉心底水平段呼吸错层下移而出现在冠状动脉水平段下方,左右冠状动脉均不受影响。心电编辑后全部12例均满足临床诊断需求,图像质量评分较编辑前大幅提高(P<0.05)。结论运用回顾性心电门控心电编辑功能移动冠状动脉水平段呼吸错层的位置并结合编辑前后的图像,可以有效避免呼吸错层对CCTA图像质量造成的重度影响,提高诊断的准确性,值得在临床上推广使用。
Objective To assess the value of clinical application of using ECG-editing technique to remove the mis-positioning artifacts(MPA) of coronary artery horizontal segments in CCTA of retrospective ECG-gated helical scan.Methods 12 patients who underwent CCTA of retrospective ECG-gated helical scan on 64 slices CT with severe MPA of coronary artery horizontal segments caused by breathing were collected.Using ECG-editing technique of retrospective ECG-gated helical scan,when MPA appeared in the proximal horizontal segments of coronary arteries,we deleted the reconstruction window before the heartbeat of the MPA and MPA moved up to the superior part of the coronary artery.When MPA appeared in the distal horizontal segments of RCA,we deleted the reconstruction window adjacent to the heartbeat of MPA and MPA moved down to inferior part of RCA.The MPA were scored with four points with the double blind method by one radiologist and one technician and processed by Wilcoxon statistics.Results Before ECG-editing,there were 5 cases in which MPA appeared in the proximal horizontal segments of LM,6 cases in proximal horizontal segments of RCA and1 case in distal horizontal segments of RCA.After ECG-editing,all 12 cases attained standard diagnostic quality.5 cases of MPA of LM moved up and at the superior part of LM,LM and RCA displayed clearly.6 cases of MPA of RCA moved up and 4 cases appeared between LM and RCA,RCA displayed clearly and LAD and LCX were slightly affected,2 cases appeared at the superior part of LM,LM and RCA displayed clearly.1 case of MPA moved down and at the inferior part of RCA,LAD,LCX and RCA displayed clearly.Conclusion Using ECG-editing technique to remove the MPA out of coronary arteries horizontal segment in CCTA caused by breathing could avoid the severe degradation of coronary artery images and improve diagnostic accuracy.
Objective To assess the value of clinical application of using ECG-editing technique to remove the mis-positioning artifacts(MPA) of coronary artery horizontal segments in CCTA of retrospective ECG-gated helical scan.Methods 12 patients who underwent CCTA of retrospective ECG-gated helical scan on 64 slices CT with severe MPA of coronary artery horizontal segments caused by breathing were collected.Using ECG-editing technique of retrospective ECG-gated helical scan,when MPA appeared in the proximal horizontal segments of coronary arteries,we deleted the reconstruction window before the heartbeat of the MPA and MPA moved up to the superior part of the coronary artery.When MPA appeared in the distal horizontal segments of RCA,we deleted the reconstruction window adjacent to the heartbeat of MPA and MPA moved down to inferior part of RCA.The MPA were scored with four points with the double blind method by one radiologist and one technician and processed by Wilcoxon statistics.Results Before ECG-editing,there were 5 cases in which MPA appeared in the proximal horizontal segments of LM,6 cases in proximal horizontal segments of RCA and1 case in distal horizontal segments of RCA.After ECG-editing,all 12 cases attained standard diagnostic quality.5 cases of MPA of LM moved up and at the superior part of LM,LM and RCA displayed clearly.6 cases of MPA of RCA moved up and 4 cases appeared between LM and RCA,RCA displayed clearly and LAD and LCX were slightly affected,2 cases appeared at the superior part of LM,LM and RCA displayed clearly.1 case of MPA moved down and at the inferior part of RCA,LAD,LCX and RCA displayed clearly.Conclusion Using ECG-editing technique to remove the MPA out of coronary arteries horizontal segment in CCTA caused by breathing could avoid the severe degradation of coronary artery images and improve diagnostic accuracy.
引文
1周运锋,韩萍.心脏和冠状动脉CT血管成像应用与进展[J].临床放射学杂志,2010,29:698-700.
2 Machida H,Tanaka I,Fukui R,et al.Current and Novel Imaging Techniques in Coronary CT[J].Radiographics,2015,35:991-1010.
3何雯雯,黄伟,周长圣,等.室性期前收缩对双源CT冠状动脉成像的影响及心电编辑的应用[J].临床放射学杂志,2011,30:508-512.
4陈宪,李真林,帅桃,等.多层螺旋CT冠状动脉成像质量影响因素探讨[J].实用放射学杂志,2011,27:1435-1437.
5梁立华,吴菊芳,陈耀强,等.64层螺旋CT冠状动脉成像伪影产生原因分析[J].中华放射学杂志,2008,42:923-926.
6 Hou Y,Yue Y,Guo W,et al.Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography:image quality and radiation dose over expanded heart rates[J].Int J Cardiovasc Imaging,2012,28:153-162.
7汪芳,郝万庆,杨利莉,等.256排宽体探测器CT智能心电门控技术在不控制心率患者冠状动脉CTA中的应用[J].中国医学影像技术,2017,33:1080-1084.
8赵磊.双源CT前瞻性心电门控大螺距螺旋扫描冠状动脉成像研究进展[J].临床放射学杂志,2011,30:1557-1559.
9尹卫华,吕滨.冠状动脉CT低剂量血管成像的研究进展[J].中国医学影像技术,2013,29:830-833.
2 Machida H,Tanaka I,Fukui R,et al.Current and Novel Imaging Techniques in Coronary CT[J].Radiographics,2015,35:991-1010.
3何雯雯,黄伟,周长圣,等.室性期前收缩对双源CT冠状动脉成像的影响及心电编辑的应用[J].临床放射学杂志,2011,30:508-512.
4陈宪,李真林,帅桃,等.多层螺旋CT冠状动脉成像质量影响因素探讨[J].实用放射学杂志,2011,27:1435-1437.
5梁立华,吴菊芳,陈耀强,等.64层螺旋CT冠状动脉成像伪影产生原因分析[J].中华放射学杂志,2008,42:923-926.
6 Hou Y,Yue Y,Guo W,et al.Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography:image quality and radiation dose over expanded heart rates[J].Int J Cardiovasc Imaging,2012,28:153-162.
7汪芳,郝万庆,杨利莉,等.256排宽体探测器CT智能心电门控技术在不控制心率患者冠状动脉CTA中的应用[J].中国医学影像技术,2017,33:1080-1084.
8赵磊.双源CT前瞻性心电门控大螺距螺旋扫描冠状动脉成像研究进展[J].临床放射学杂志,2011,30:1557-1559.
9尹卫华,吕滨.冠状动脉CT低剂量血管成像的研究进展[J].中国医学影像技术,2013,29:830-833.