【摘要】：目的：探討第二代雙源CT (dual-source CT, DSCT)評估左心室功能參數(shù)[左室射血分數(shù)(left ventricular ejection fraction,LVEF)、鐕左室舒張末期容積(end-diastolic volume, EDV)、左室收縮末期容積(end-systolic volume, ESV)、每搏輸出量(stroke volume, SV)]的準確性,并與超聲心動圖進行對比。 材料與方法：入選60例臨床上可疑或確診冠心病患者,所有患者均在72小時內(nèi)采用第二代DSCT回顧性心電門控的方法進行常規(guī)冠狀動脈掃描及超聲心動圖檢查。分為兩組,每組30例患者。組1為全劑量組(在心電門控非最大管電流調(diào)制情況下掃描),組2為非全劑量組(在心電門控最大管電流調(diào)制情況下掃描)。測量60例患者的DSCT和心超的EF、EDV、ESV、SV數(shù)據(jù),評估兩種檢查方法的相關性,以及組1和組2之間圖像質(zhì)量評分。同時記錄患者輻射劑量。 結(jié)果：DSCT和心超所測得的LVEF、EDV、ESV、SV值有很好的相關性(組1：EFr=0.861, EDV r=0.976, ESV r=0.977, SV r=0.950;組2：EF r=0.898, EDV r=0.947, ESV r=0.963, SV r=0.917;P值均0.001)。組2的EDV圖像質(zhì)量評分明顯低于組1(P0.001),但不影響左心室功能參數(shù)的評估,兩組患者的CT心功能參數(shù)與心超結(jié)果都有很好的一致性。結(jié)果顯示,除組1DSCT與心超測得的ESV值有統(tǒng)計學差異(P=0.038),余DSCT計算出的參數(shù)與心超結(jié)果沒有統(tǒng)計學差異(P0.05)�；颊叩钠骄椛鋭┝浚航M1=7.12±2.23mSv；組2=3.70±0.89mSv。 結(jié)論：以心超所測得的數(shù)據(jù)為對照,DSCT可以提供可靠的LVEF、EDV、ESV、 SV測量結(jié)果。雖然組2的EDV圖像質(zhì)量評分要明顯低于組1(P0.001),但這并不影響左室功能參數(shù)的測定,即在非全劑量情況下就可以獲得可靠的心功能參數(shù)結(jié)果,這樣有利于降低患者的輻射劑量。
[Abstract]:Objective: to investigate the evaluation of left ventricular function parameters (left ventricular ejection fraction (left ventricular ejection fraction,LVEF), left ventricular end-diastolic volume (end-diastolic volume, EDV),) and left ventricular end-systolic volume (end-systolic volume,) by second-generation dual-generation CT (dual-source CT, DSCT) in evaluating left ventricular function [left ventricular ejection fraction (left ventricular ejection fraction,LVEF)]. The accuracy of ESV), per beat output (stroke volume, SV) was compared with that of echocardiography. Materials and methods: 60 patients with suspected or confirmed coronary heart disease were enrolled in this study. All patients underwent routine coronary artery scanning and echocardiography within 72 hours with the second generation DSCT retrospective electrocardiogram. The patients were divided into two groups, 30 patients in each group. Group 1 was a full dose group (scanned under the condition of ECG gated non-maximum current modulation) and group 2 was a non-full dose group (scan under the condition of ECG gated maximum tube current modulation). The EF,EDV,ESV,SV data of DSCT and cardiac ultrasound were measured in 60 patients to evaluate the correlation between the two methods and the image quality score between group 1 and group 2. Radiation dose was also recorded. Results: there was a good correlation between DSCT and LVEF,EDV,ESV,SV measured by cardiac ultrasound (group 1: EFr0. 861, EDV rnr 0. 976, ESV rnr 0. 977, SV rn 0. 950, 2:EF rn 0. 898, EDV rn 0. 947, ESV rn 0. 963, SV rn 0. 917). P values were 0.001). The EDV image quality score of group 2 was significantly lower than that of group 1 (P0. 001), but it did not affect the evaluation of left ventricular function parameters. The CT cardiac function parameters of both groups were in good agreement with the results of cardiac hypertrophy. The results showed that there was statistical difference in ESV between 1DSCT and cardiac hypertrophy (P0. 038), but there was no statistical difference between the parameters calculated by DSCT and the results of cardiac hypertrophy (P0.05). The average dose of radiation: group 1: 7. 12 鹵2. 23 mSv, group 2: 3. 70 鹵0. 89 mSv. Conclusion: DSCT can provide reliable LVEF,EDV,ESV, SV results in comparison with the data measured by cardiac ultrasound. Although the EDV image quality score of group 2 was significantly lower than that of group 1 (P0. 001), this did not affect the measurement of left ventricular function parameters, that is, reliable results of cardiac function parameters could be obtained at a non-full dose. This helps to reduce the radiation dose of the patient.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R816.2;R540.45

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