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目的探讨影响64排螺旋CT(64MDCT)冠状动脉成像图像质量的因素。方法对186例临床诊断或拟诊冠心病患者行64MDCT冠状动脉成像,使用Philips独立工作站提供的冠状动脉分析软件,进行冠状动脉后处理重组,对重组图像进行评分,记录患者的年龄、性别、呼吸、体重、吸烟及饮酒史、慢性病史(糖尿病或高血压)、支架置入史、扫描时的平均心率、心律变化、对比剂的用量及注射速率、最佳R-R时相、软斑块、心肌桥、冠状动脉发育异常、钙化积分并相应评分,分析上述因素与冠状动脉评分的相关性,统计学处理采用多元线性回归模型。结果重建时相、钙化积分、心率、软斑块、心律变化对图像质量的影响有统计学意义,上述因素与图像质量间具有多元线性回归关系(标准化回归系数分别为0.357,0.237,-0.195,-0.195,-0.166,-0.152)。结论对患者心率和心律变化的良好控制及选择最佳R-R时相重建冠状动脉,可最低限度地减轻心脏运动伪影,提高冠状动脉血管的成像质量,了解钙化及软斑块对图像质量的影响可以恰当评估冠状动脉软、硬斑块面积及管腔的狭窄程度,提高多排探测器CT对冠心病的诊断准确性。
Objective To explore the factors influencing the quality of 64-slice spiral CT (64MDCT) coronary angiography. Methods Sixty-six patients with clinically diagnosed or diagnosed CHD underwent 64-MDCT coronary angiography. Coronary artery analysis software provided by Philips independent workstation was used to perform post-treatment and reorganization of coronary arteries. The images were graded and the age, sex, , Body weight, history of smoking and drinking, history of chronic disease (diabetes or hypertension), history of stenting, average heart rate at scan, changes in heart rate, contrast medium dosage and injection rate, optimal RR phase, soft plaque, Bridge, coronary artery abnormalities, calcification scores and the corresponding score, analysis of the above factors and coronary artery score correlation, statistical analysis using multiple linear regression model. Results The reconstruction phase, calcification score, heart rate, soft plaque and heart rate had a significant effect on the image quality. There was a multiple linear regression between the above factors and the image quality (the standardized regression coefficients were 0.357, 0.237, -0.195, -0.195, -0.166, -0.152). Conclusions The good control of heart rate and heart rate changes and the optimal reconstruction of coronary artery in the optimal RR phase can reduce heart motion artifacts and improve the imaging quality of coronary vessels and the influence of calcification and soft plaque on the image quality Coronary artery can be properly evaluated soft and hard plaque area and the degree of stenosis, improve the multi-detector CT diagnostic accuracy of coronary heart disease.