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目的:探讨影响双源CT冠状动脉造影成像质量的因素,并提出相应措施以提高图像质量。方法:随机抽取2009年1月～2011年1月南京医科大学附属无锡市人民医院进行双源CT冠状动脉造影的300例患者的图像作为对照组,提出质量评价标准,按优到差评估分为Ⅰ～Ⅳ级,并对造成冠脉成像质量下降的影响因素进行分析;抽取2011年2月～8月通过改良措施后进行检查的300例患者的图像作为改良组进行质量对比。结果:两组图像质量分级,对照组:Ⅰ级:232例(77.3%);Ⅱ级:48例(16.0%);Ⅲ级:16例(5.3%);Ⅳ级:4例(1.3%);影响因素依次为:冠脉严重钙化、呼吸伪影、严重心律失常伪影、上腔静脉及右房高密度造影剂产生的伪影、监测层面触发点选择不当、重建时相选择不当。改良组:Ⅰ级:263例(87.7%);Ⅱ级:26例(8.7%);Ⅲ级:10例(3.3%);Ⅳ级:1例(0.3%)。两组图像质量差异有统计学意义(P<0.01)。结论:优化CT扫描参数,准确分析冠状动脉成像伪影的成因,并提出相应措施,对提高冠脉成像质量具有重要的意义。
Objective: To explore the factors that affect the quality of dual-source CT coronary angiography and to propose corresponding measures to improve the image quality. Methods: From January 2009 to January 2011, Wuxi City People’s Hospital Affiliated to Nanjing Medical University carried out dual-source CT coronary angiography in 300 patients as a control group, the quality evaluation criteria were put forward, according to excellent to poor evaluation is divided into Ⅰ ~ Ⅳ grade, and the factors that caused the decline of coronary angiography were analyzed. The images of 300 patients who were examined after the improvement measures from February to August in 2011 were selected as the improvement group for quality comparison. Results: The quality of the two groups was graded. The control group consisted of 232 cases (77.3%) of grade Ⅰ, 48 cases (16.0%) of grade Ⅱ, 16 cases (5.3%) of grade Ⅲ and 4 cases (1.3% ), Followed by severe coronary calcification, respiratory artifacts, severe arrhythmia artifacts, artifacts caused by superior vena cava and right atrial high-density contrast agent. The selection of triggering points in monitoring level was improper and the timing of reconstruction was improperly selected. In the improved group, Grade I was 263 (87.7%), Grade II was 26 (8.7%), Grade III was 10 (3.3%), and Grade IV was 1 (0.3%). There was a significant difference in image quality between the two groups (P <0.01). Conclusion: To optimize the parameters of CT scan and analyze the causes of coronary artery imaging artifacts accurately and put forward the corresponding measures are of great significance to improve the quality of coronary artery imaging.