本文選題：冠狀動脈 + X線計算機體層攝影術��； 參考：《蘇州大學》2012年碩士論文

【摘要】：目的：分析采用個體化心率控制技術后對于指導冠狀動脈CT血管成像是否有效，并討論其價值，為實施個體化輻射劑量管理提供依據(jù)。 資料和方法：本課題為回顧性研究。選取909例CCTA檢查患者，將前360例列為第一階段，將后549例列為第二階段；每個階段根據(jù)患者基礎心率分為5個亞組。兩個階段分別采用不同的心率控制技術。（1）分別比較兩個階段中不同亞組的基礎HR、基礎HRV、服藥總量、到達心率穩(wěn)定期時間、預測HR、預測HRV、掃描HR、掃描HRV，計算預測HR、預測HRV的下降程度，并分析兩個階段中預測HR與掃描HR的相關性；（2）分析第二階段中預測HR、HRV與各掃描階段中HR、HRV的變化趨勢；（3）計算第二階段中預測HR、HRV的準確度；（4）比較第二階段中患者采用個體化心率控制技術后CCTA掃描的有效劑量（ED）及模擬有效劑量，評價三種不同掃描模式下的圖像質(zhì)量。 結果：（1）兩個階段各組患者的基礎HR、基礎HRV差異均無統(tǒng)計學意義（P0.05）。（2）除55bpm組外，第二階段的倍他樂克給藥量明顯高于第一階段（P0.05）。（3）患者平均到達心率穩(wěn)定期時間為5.8秒，最短為4秒，最長為9秒。（4）第一階段HR≥55bpm及第二階段所有患者的預測HR均低于基礎HR（P0.05），與基礎HR相比，第一階段預測HR總體下降12.4%，第二階段預測HR總體下降15.1%；第一階段HR≤84bpm組及第二階段所有患者預測HRV均低于基礎HRV（P0.05），與基礎HRV相比，第一階段預測HRV總體下降30.1%，第二階段預測HRV總體下降52.1%。（5）預測HR與掃描HR相關系數(shù):第一階段r=0.646，第二階段r=0.574。（6）第二階段HR于正位標繪圖階段時明顯升高隨之下降，HRV于TESTBLOUS階段時明顯升高。（7）以掃描HR為基準，第二階段預測HR與掃描HR在±5bpm者461例（84.0%），以掃描HRV為基準，預測HRV與掃描HRV在±5bpm者532例（96.9%）。（8）采用個體化心率控制技術后理論上可降低CCTA檢查有效劑量22.5%。（9）采用單扇區(qū)點期相掃描患者圖像質(zhì)量評分1.52±0.83，單扇區(qū)半期相掃描1.62±0.90，二者無顯著性差異（P0.05），均高于雙扇區(qū)半期相掃描3.75±0.89（P0.05）。 結論：采用個體化心率控制技術可以有效降低心率及心率變異度，，并且能夠很好的預測患者掃描心率及心率變異度，同時提高單扇區(qū)點期相掃描的成功率，保證優(yōu)質(zhì)的圖像質(zhì)量，并有效降低輻射劑量。
[Abstract]:Objective: to analyze the effectiveness of individualized heart rate control technique in guiding coronary artery CT angiography and discuss its value in order to provide basis for individualized radiation dose management. Data and methods: this subject is a retrospective study. 909 patients with CCTA were selected, the first 360 patients were selected as the first stage and the latter 549 patients as the second stage, each stage was divided into 5 subgroups according to the patients' basic heart rate. In the two stages, different heart rate control techniques were used to compare the basic HRs, the basic HRVs, the total amount of medication, and the time to reach the stable heart rate in different subgroups of the two stages. Predict HRV, predict HRV, scan HRV, scan HRV, calculate predicted HRR, predict the degree of HRV decline, And analyze the correlation between HR-predicted HR-scan HR in the two phases and the correlation between HR-HRV prediction in the second stage and HR-HRV in each scanning stage. The accuracy of predicting HRV in the second stage is compared with that in the second stage. The accuracy of HRV prediction in the second stage is compared with that in the second stage. The effective dose of CCTA scan and the simulated effective dose after individualized heart rate control, To evaluate the image quality of three different scanning modes. Results (1) there was no significant difference in basic HRV and basal HRV between the two groups. Except for the 55bpm group, the dosage of betaloc in the second stage was significantly higher than that in the first stage (P 0.05). The average time to the stable period of heart rate was 5.8 seconds, and the shortest was 4 seconds. In the first stage, the HR 鈮

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