平均心率、心率波动和心率变异性对双源CT冠状动脉影像质量影响的研究

目的：评价平均心率、心率波动和心率变异性对双源CT冠状动脉影像质量的影响。方法：100例患者进行了双源CT冠状动脉血管成像。原始数据经多期相重建优选出最佳收缩期和舒张期影像，以4分法评定系统进行影像质量评价。利用Pearson相关分析评价平均心率、心率波动和心率变异性对冠状动脉的影像质量的影响，对有相关性者行进一步分析。结果：100例患者，共纳入分析的血管为299支，296支血管可满足影像评价（99％）。平均心率、心率波动和心率变异性对总的冠状动脉影像质量没有影响，仅平均心率对舒张期冠状动脉影像质量有负影响（P〉0．05），尤其对右冠状动脉的影响更明显，70bpm以上时影像质量即下降，80bpm以上时影像质量甚至难以满足评价。结论：平均心率、心率波动和心率变异性对双源cr冠状动脉总的影像质量没有影响，但平均心率对舒张期冠状动脉的影像质量有负影响，对右冠状动脉的影响更大，当心率大于80bpm时，利用舒张期的数据难以获得RCA满意的影像质量，应该利用最佳收缩期的数据进行影像重组。

Coronary angiography with dual-source CT: the effect of average heart rate, heart rate range, and heart rate variability on image quality

Objective：The purpose of this study was to assess the effect of average heart rate （HR）, heart rate range, and heart rate variability on image quality of noninvasive coronary angiography with dual-source CT （DSCT）. Methods： 100 patients underwent dualsource CT coronary angiography. Multiple phase data were reconstructed to assess best systohc and diastolic image quality of coronary angiography. Image quality was performed using four-score method. Pearson correlation analysis was used to evaluate the relationship of HR, heart rate range, and heart rate variability on image quality of noninvasive coronary angiography with dual-source CT （DSCT）. Further detailed analysis was performed if statistical significance was found. Results：299 coronary arteries were analyzed in 100 patients, 296 vessels had assessable image quality （99%）. HR, heart rate range, and heart rate variability had no correlation with average image quality of noninvasive coronary angiography; negative correlation was found for HR and diastolic image quality of coronary arteries （ P 〉 0.05）, especially for the right coronary artery （RCA）. Image quality of RCA was deteriorated at HR of higher than 70 bpm, even nonassessable at HR of higher than 80 bpm. Conclusion： Average HR, heart rate range, and heart rate variability have no correlation with average image quality of noninvasive coronary angiography with DSCT; negative correlation is found for HR and diastolic image quality of coronary arteries, especially for RCA. Systolic phase data should be used to reconstruct for the patients with heart rate higher than 80 bpm because of nonassessable diastolic image quality of RCA.