前瞻性心电门控大螺距血管成像技术对Stanford A型主动脉夹层根部病变的诊断价值

发布时间：2018-09-06 19:47

【摘要】：目的评价128层双源CT前瞻性心电门控大螺距血管成像技术对Stanford A型主动脉夹层根部病变诊断的准确性。方法选取2015年10月至2016年2月本院可疑Stanford A型主动脉夹层患者,在不控制心率的情况下使用双源大螺距前瞻心电触发全主动脉成像(FLASH,螺距3.2),对其中明确诊断的Stanford A型主动脉夹层且进行手术治疗的35例与同期非心电门控CT血管造影(CT angiography,CTA)诊断的27例Stanford A型主动脉夹层进行比较,以术中所见为参考标准,评价其对主动脉窦、主动脉瓣交界、冠状动脉及窦管交界的受累情况诊断的准确性。结果 CTA距离手术平均时间为(3.38±7.20)天,FLASH组与对照组患者流行病学特征及扫描范围差异无显著性;根部图像质量均可满足诊断,对主动脉窦受累评价敏感性和特异性分别为95.3%、98.4%,对主动脉瓣交界的受累评价敏感性和特异性分别为96%、96.2%;对冠状动脉受累诊断的敏感性和特异性分别为76.5%、98.1%。FLASH组扫描时间为(1.55±0.07)秒,有效辐射剂量(4.13±1.12)m Sv,均低于对照组。结论前瞻性心电门控大螺距主动脉CTA对Stanford A型主动脉夹层根部评价准确性明显高于非心电门控组,且有效辐射剂量和对比剂用量低于对照组。
[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 卤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 卤0. 07) seconds. The effective radiation dose (4.13 卤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.
【作者单位】：首都医科大学附属北京安贞医院医学影像科;首都医科大学附属北京安贞医院心血管外科;
【基金】：北京市科技计划(Z141100000214010)
【分类号】：R543.1;R816.2

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