| 经齐峰,周巧娟,王灿云,谭雁,沈水军.双低左心房CTA检查的图像质量及影响因素分析[J].浙江中西医结合杂志,2025,35(8): |
| 双低左心房CTA检查的图像质量及影响因素分析 |
| Analysis of Image Quality and Influencing Factors of Double Low Left Atrial CTA Examination |
| 投稿时间：2025-01-23 修订日期：2025-03-23 |
| DOI： |
| 中文关键词: CT血管造影 左心房 低对比剂 低管电压 |
| 英文关键词:CT angiography Left atrium Low contrast agent Low tube voltage |
| 基金项目:杭州市萧山区重大科技计划项目(No.2022337) |
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| 中文摘要: |
| 目的 基于CT双低左心房造影(CTA)检查,探讨影响图像质量的因素。方法 采用回顾性研究,收集2023年6月-2024年12月共30例确诊为房颤考虑行左心耳封堵术的患者,记录每位患者的性别、年龄、身高、体重、心率、收缩压、舒张压、空腹血糖、低密度脂蛋白等信息。所有患者行双低剂量(管电压80kv,造影剂浓度320mg/ml)CTA检查,检查完成后进行图像重建,选择左心耳层面的胸主动脉、肺静脉汇集处、左心房中心及胸大肌4个位置的图像进行分析,记录CT值、信噪比(signal-to-noise ratio, SNR)、对比噪声比(contrast-to-noise ratio, CNR)及主观评分值。用SPSS.23软件进行统计学分析,用 Spearman进行相关性检验,根据结果再用逐步线性回归法分析独立影响因素。结果 相关分析结果显示,在左心耳层面,低密度脂蛋白(r=-0.428)和体重(r=-0.454)与图像SNR呈负相关,年龄(r=0.404)与图像CNR呈正相关,舒张压(r=-0.486)和体重(r=-0.747)与图像CNR呈负相关,P<0.05；在肺静脉汇集处层面,体重(r=-0.459)与图像SNR呈负相关,身高(r=-0.475)、体重(r=-0.692)及舒张压(r=-0.438)与图像CNR呈负相关,P<0.05；在左心房中心层面,体重(r=-0.519)与图像SNR呈负相关,性别(r=0.408)与图像CNR呈正相关,身高(r=-0.539)、体重(r=-0.796)及舒张压(r=-0.524)与图像CNR呈负相关,P<0.05。逐步多元线性逐步回归分析显示：在左心耳层面,体重是影响图像SNR的独立影响因素(P<0.05),体重和舒张压是图像CNR的独立影响因素(P<0.05)；在肺静脉汇集处和左心房中心层面,体重和舒张压是图像CNR的独立影响因素(P<0.05)。结论 体重和舒张压是双低剂量左心房CTA图像质量的独立影响因素,基于这两个因素调整扫描方案有利于提高图像质量。 |
| 英文摘要: |
| Objective Based on CT double low left atrial angiography (CTA) examination, to explore the factors affecting image quality。Method A retrospective study was conducted to collect information on 30 patients diagnosed with atrial fibrillation and considering left atrial appendage occlusion surgery from June 2023 to December 2024. The patient"s gender, age, height, weight, heart rate, systolic blood pressure, diastolic blood pressure, fasting blood glucose, low-density lipoprotein, and other relevant data were recorded. All patients underwent dual low-dose (tube voltage 80kv, contrast agent concentration 300mg/ml) CTA examination. After the examination was completed, image reconstruction was performed, and images of the thoracic aorta, pulmonary vein confluence, left atrial center, and pectoralis major muscle at the left atrial appendage level were selected for analysis. CT values, signal-to-noise ratio (SNR), contrast to noise ratio (CNR), and subjective scoring values were recorded. Perform statistical analysis using SPSS.23 software, conduct correlation tests using Spearman, and analyze independent influencing factors using stepwise linear regression based on the results. Result The correlation analysis results showed that at the left atrial appendage level, low-density lipoprotein (r=-0.428) and body weight (r=-0.454) were negatively correlated with image SNR, age (r=0.404) was positively correlated with image CNR, and diastolic blood pressure (r=-0.486) and body weight (r=-0.747) were negatively correlated with image CNR, P<0.05；At the level of pulmonary vein convergence, weight (r=-0.459) is negatively correlated with image SNR, while height (r=-0.475), weight (r=-0.692), and diastolic blood pressure (r=-0.438) are negatively correlated with image CNR, P<0.05；At the central level of the left atrium, weight (r=-0.519) is negatively correlated with image SNR, gender (r=0.408) is positively correlated with image CNR, height (r=-0.539), weight (r=-0.796), and diastolic blood pressure (r=-0.524) are negatively correlated with image CNR, P<0.05。Stepwise multiple linear stepwise regression analysis showed that at the left atrial appendage level, weight was an independent factor affecting image SNR (P<0.05), while weight and diastolic blood pressure were independent factors affecting image CNR (P<0.05); Body weight and diastolic blood pressure were independent influencing factors of image CNR at the pulmonary vein confluence and left atrial central level (P<0.05). Conclusion Body weight and diastolic blood pressure are independent influencing factors for dual low-dose left atrial CTA scanning, and adjusting the scanning scheme based on these two factors is beneficial for improving image quality. |
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