冠状动脉追踪冻结技术在前瞻性和回顾性心电门控下改善CTCA图像质量

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摘要目的：评估冠状动脉追踪冻结技术（Snapshot freeze，SSF）在改善CT冠状动脉成像（CTCA）图像质量中的作用。方法：30例进行前瞻性心电门控扫描，30例进行回顾性心电门控扫描，比较标准算法（Standard，STD）重建和SSF重建两种方法的图像质量和可判读性。所获图像由2位医师按Likert 5分制标准对每一冠状动脉节段、每支冠状动脉及每例冠状动脉进行评分。结果：前门控扫描30例，SSF算法重建图像的可判读性按每支（97.8%（88/90） vs 87.8%（79/90），P=0.004）及每段（99.1%（427/431） vs 96.1%（414/431），P=0.000）比较高于STD算法重建图像；图像质量按例数（3.5±0.9 vs 2.9±1.2，P=0.004）、每支（3.5±0.8 vs 3.1±1.0，P=0.000）和每段（3.7±0.8 vs 3.4±1.0，P=0.000）比较，SSF算法均高于STD算法重建图像。后门控扫描30例，45%期相SSF算法重建图像可判读性按例（80.0%（24/30） vs 53.3%（16/30），P=0.039）、分支（90.0%（81/90） vs 71.1%（64/90），P=0.000）、节段（98.1%（413/421） vs 90.7%（382/421），P=0.000）均高于STD算法重建图像；75%期相SSF算法重建图像可判读性按分支（70.0%（63/90） vs 55.6%（50/90），P=0.02）和节段（82.7%（348/421） vs 78.4%（330/421），P=0.018）比较高于STD算法重建图像，SSF算法45%和75%期相图像质量按例数（2.8±1.0 vs 2.1±1.2，P=0.012）（2.1±1.2 vs 1.6±1.0，P=0.026）、分支（3.0±0.9 vs 2.4±1.0，P=0.000）（2.6±1.2 vs 2.2±1.2，P=0.000）和节段（3.3±0.9 vs 2.9±1.0，P=0.000）（2.9±1.2 vs 2.7±1.1，P=0.000）比较均明显高于STD算法重建图像。结论：冠状动脉SSF技术能明显提高前门控和后门控冠状动脉CT图像质量及可判读性，其中对后门控45%期相重建的右冠状动脉图像质量改善作用最为明显。

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	张计旺1
	范丽娟1
	徐冬生1
	董智1
	李旭1
	张立仁1
	于铁链2

关键词 ：体层摄影术, 螺旋计算机, 冠状血管造影术

Abstract：Objective: To assess snapshot freeze(SSF) motion correction algorithm for its value on image quality of computed tomography cornorary angiography(CTCA). Methods: Thirty patients underwent CTCA with prospective ECG-gating and 30 patients underwent CTCA with retrospective ECG-gating. Image quality and interpretability were compared between standard(STD) and SSF reconstructions algorithms. According to Likert 5-points score, score of every segment, branch and cases of patient were interpreted by two experienced radiologists. Results: Thirty patients underwent prospective ECG-gating CTCA and 30 patients underwent retrospective ECG-gating. In prospective ECG-gating group: SSF showed higher interpretability than STD on per-artery(97.8%(88/90) vs 87.8%(79/90), P=0.004) and per-segment level(99.1%(427/431) vs 96.1%(414/431), P=0.000). Image quality was higher with SSF than STD on per-patient(3.5±0.9 vs 2.9±1.2, P=0.004), per-artery(3.5±0.8 vs 3.1±1.0, P=0.000) and per-segment levels(3.7±0.8 vs 3.4±1.0, P=0.000). In retrospective ECG-gating group: SSF showed higher interpretability than STD on per-patient(80.0%(24/30) vs 53.3%(16/30), P=0.039), per-artery(90.0%(81/90) vs 71.1%(64/90), P=0.000), and per-segment levels(98.1%(413/421) vs 90.7%(382/421), P=0.000) of 45% R-R interval images. SSF showed higher interpretability than STD on per-artery(70.0%(63/90) vs 55.6%(50/90), P=0.02) and per-segment levels(82.7%(348/421) vs 78.4%(330/421), P=0.018). Image quality were higher with SSF than STD on per-patient(2.8±1.0 vs 2.1±1.2, P=0.013) (2.1±1.2 vs 1.6±1.0, P=0.026), per-artery(3.0±0.9 vs 2.4±1.0, P=0.000) (2.6±1.2 vs 2.2±1.2, P=0.000) and per-segment levels(3.3±0.9 vs 2.9±1.0, P=0.000) (2.9±1.2 vs 2.7±1.1, P=0.000) of 45% and 75% R-R interval images. Conclusion: SSF could improve the image quality and interpretability of CTCA with prospective and retrospective ECG-gating. Especially, SSF could improve the image quality on RCA by using the 45% R-R interval as the central phase with retrospective ECG-gating.

Key words： Tomography, spiral computed Coronary angiography

收稿日期: 2015-08-11

PACS:	Ｒ814.42
	Ｒ814.43

基金资助:滨海新区卫生局重点支持科技项目（2013BWKZ008）

通讯作者: 范丽娟，泰达国际心血管病医院放射科，300457。E-mail：lijuanfan111@163.com

作者简介: 张计旺（1979-），男，河北人，主治医师。E-mail：zhangjiwang80@163.com

引用本文:

张计旺1，范丽娟1，徐冬生1，董智1，李旭1，张立仁1，于铁链2. 冠状动脉追踪冻结技术在前瞻性和回顾性心电门控下改善CTCA图像质量[J]. 中国临床医学影像杂志, 2016, 27(4): 252-256.
ZHANG Ji-wang1, FAN Li-juan1, XU Dong-sheng1, DONG Zhi1, LI Xu1, ZHANG Li-ren1, YU Tie-lian2. Improving CTCA image quality by using snapshot freeze technique under prospective and retrospective ECG-gating. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(4): 252-256.

链接本文:

http://www.jccmi.com.cn/CN/ 或 http://www.jccmi.com.cn/CN/Y2016/V27/I4/252

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