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目的探讨心率对多层螺旋CT冠状动脉造影图像质量的影响和最佳重建相位窗的选择。方法回顾性分析67例患者16层螺旋CT心电门控条件下冠状动脉造影图像。按心率分成≤60次/min、61～70次/min、71～80次/min和≥81次/min分成第1～4组,将冠状动脉图像按伪影多少及血管连续性分为1～3分,评价心率与图像质量的关系,并优选出各组显示冠状动脉的最佳相位窗。结果对每位患者4条冠状动脉(右冠状动脉、左冠状动脉主干、左前降支、左回旋及图像质量进行研究。心率≤60次/min,可用于分析的图像占86.7%;心率61～70次/min,可用于分析的图像占62.5%;心率71～80次/min,可用于分析的图像占40%;心率≥81次/min,可用于分析的图像占12.5%。第1、2组与第3、4组间冠脉总的检查成功率有统计学差异(P<0.05)。第1组所有冠状动脉节段以75%相位窗为最佳;第2组冠状动脉节段以75%为最佳相位窗占89.5%,第3组左右冠状动脉以45%和75%为最佳相位窗分别占45%和55%,第4组全部冠状动脉节段以45%为最佳相位窗。结论心率对多层螺旋CT冠状动脉造影图像质量有重要影响;心率70次/min以下冠状动脉最佳相位窗通常为75%,心率71次/min以上时,应该以30%～90%多相位重建。
Objective To investigate the effect of heart rate on the quality of coronary angiography images and the best reconstructed phase window. Methods A retrospective analysis of 67 patients underwent 16-slice spiral CT coronary angiography under coronary angiography. The heart rate was divided into ≤60 times / min, 61 ~ 70 times / min, 71 ~ 80 times / min and ≥81 times / min were divided into groups 1 ~ 4, the coronary arteries were divided according to artifacts and vascular continuity ~ 3 points, evaluate the relationship between heart rate and image quality, and optimize the optimal phase window of each group shows coronary artery. Results Four coronary arteries (right coronary artery, left main coronary artery, left anterior descending artery, left circumflex artery and image quality were studied in each patient.) Heart rate ≤ 60 beats / min, images available for analysis accounted for 86.7%, heart rate 61 ~ 70 times / min, can be used for analysis of images accounted for 62.5%; heart rate 71 ~ 80 times / min, can be used for analysis of images accounted for 40%; heart rate ≥ 81 times / min, 12.5% There was a significant difference in the total success rate of coronary arteries between the two groups and the third and fourth groups (P <0.05) .Among all the coronary arteries in group 1, 75% of the phase windows were the best, while the second group of coronary arteries 75% of the best phase window accounted for 89.5%, 45% and 75% of the 45th and 75% of the coronary arteries in the third group accounted for 45% and 55%, respectively, and the fourth group all coronary artery segments 45% Good phase window.Conclusion The heart rate has an important influence on the quality of coronary angiography images of multislice spiral CT.The optimum phase window of coronary arteries below 70 beats / min is usually 75%, and the heart rate should be 30% 90% multi-phase reconstruction.