【摘要】：目的評(píng)價(jià)128層雙源CT前瞻性心電門控大螺距血管成像技術(shù)對(duì)Stanford A型主動(dòng)脈夾層根部病變?cè)\斷的準(zhǔn)確性。方法選取2015年10月至2016年2月本院可疑Stanford A型主動(dòng)脈夾層患者,在不控制心率的情況下使用雙源大螺距前瞻心電觸發(fā)全主動(dòng)脈成像(FLASH,螺距3.2),對(duì)其中明確診斷的Stanford A型主動(dòng)脈夾層且進(jìn)行手術(shù)治療的35例與同期非心電門控CT血管造影(CT angiography,CTA)診斷的27例Stanford A型主動(dòng)脈夾層進(jìn)行比較,以術(shù)中所見為參考標(biāo)準(zhǔn),評(píng)價(jià)其對(duì)主動(dòng)脈竇、主動(dòng)脈瓣交界、冠狀動(dòng)脈及竇管交界的受累情況診斷的準(zhǔn)確性。結(jié)果 CTA距離手術(shù)平均時(shí)間為(3.38±7.20)天,FLASH組與對(duì)照組患者流行病學(xué)特征及掃描范圍差異無顯著性;根部圖像質(zhì)量均可滿足診斷,對(duì)主動(dòng)脈竇受累評(píng)價(jià)敏感性和特異性分別為95.3%、98.4%,對(duì)主動(dòng)脈瓣交界的受累評(píng)價(jià)敏感性和特異性分別為96%、96.2%;對(duì)冠狀動(dòng)脈受累診斷的敏感性和特異性分別為76.5%、98.1%。FLASH組掃描時(shí)間為(1.55±0.07)秒,有效輻射劑量(4.13±1.12)m Sv,均低于對(duì)照組。結(jié)論前瞻性心電門控大螺距主動(dòng)脈CTA對(duì)Stanford A型主動(dòng)脈夾層根部評(píng)價(jià)準(zhǔn)確性明顯高于非心電門控組,且有效輻射劑量和對(duì)比劑用量低于對(duì)照組。
[Abstract]:Objective to evaluate the accuracy of 128 layer dual source CT prospective ECG gated large pitch angiography in the diagnosis of Stanford A aortic dissection. Methods patients with suspected Stanford A aortic dissection from October 2015 to February 2016 were selected. Using dual source large pitch prospective ECG trigger total aortic imaging (FLASH, pitch 3.2) without heart rate control, 35 patients with Stanford type A aortic dissection who underwent surgical treatment were compared with non-ECG gated CT vessels in the same period. 27 cases of Stanford A aortic dissection diagnosed by CT angiography,CTA were compared. The diagnostic accuracy of aortic sinus, aortic valve junction, coronary artery and sinus junction was evaluated. Results the average operation time of CTA was (3.38 鹵7.20) days. There was no significant difference in the epidemiological characteristics and scanning range between the flash group and the control group, and the quality of the root images could satisfy the diagnosis. The sensitivity and specificity of assessing the involvement of aortic sinus were 95.398. 4, the sensitivity and specificity of assessing the involvement of aortic junction were 96. 62, and the sensitivity and specificity of diagnosis of coronary artery involvement were 76. 5 and 98. 1% respectively. The scanning time of flash group was (1. 55 鹵0. 07) seconds. The effective radiation dose (4.13 鹵1.12) m Sv,) was lower than that in the control group. Conclusion the accuracy of prospective ECG gated large pitch aortic CTA in evaluating the root of Stanford A aortic dissection is significantly higher than that in non-ECG gated group, and the effective radiation dose and contrast agent dosage are lower than those in the control group.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院醫(yī)學(xué)影像科;首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院心血管外科;
【基金】：北京市科技計(jì)劃(Z141100000214010)
【分類號(hào)】：R543.1;R816.2

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