層CT在冠狀動(dòng)脈CTA中的應(yīng)用幻燈

1、Application of 256-slice CT Application of 256-slice CT in coronary CTAin coronary CTAApplication of 256-slice CT in coronary CTA2CTA with Reduced Radiation DoseCTA with high heart rateReduced Radiation Dose364-slice:15-20mSv - 7501000 Chest film4Reduced Radiation DoseReported effective radiation do

2、sage in recent studies with the use of 64detector row CT have ranged from 9.5 to 21.4 mSv, more than the previously reported d-oses from 16detector row CT studies.James P, Elise L, Bruce A, et al. Prospectively Gated Transverse Coronary CT Angiography versus Retrospectively Gated Helical Technique:

3、Improved Image Quality and Reduced Radiation Dose. Radiology 2008;246:742-75316-detector64-detector256-detectorMore doseage？More doseage5Reduced Radiation Dose530-46%12-24%17-33%80%3 multipleDoseWise provedproved New32-40%6Reduced Radiation DoseRetrospectively ECG-triggered scanProspectively ECG-tri

4、ggered scanProspectively gated transverse CT technique represents an 83% reduction as compared with that for the group with the retrospectively gated helical technique。James P, Elise L, Bruce A, et al. Prospectively Gated Transverse Coronary CT Angiography versus Retrospectively Gated Helical Techni

5、que: Improved Image Quality and Reduced Radiation Dose. Radiology 2008;246:742-753Reduced Radiation Dose7 Larger coverage: 80 mm For a typical cardiac scan (120 mm) Two axial shots 3 Heart beats 4-5 second scans Less vulnerability to irregularity / arrhythmia More reliable performance in scan after

6、scanStep & Shoot Cardiac scan1Step:23256slice320sliceReduced Radiation Dose a b c d e 圖像區(qū)圖像區(qū)SpiralOverscanReduced Radiation Dose10Patient: CT檢查時(shí)條件設(shè)置檢查時(shí)條件設(shè)置 Xiong shu yan ,woman,46Height:162mm,Weight：52KGBMI：19.8Symptom：chest painRadiation doseCTDIvol* Scan Length*0.0141.4mGy* 11.04*0.014=0.21mSv

7、Case of low dose-Prospectively ECG-Gated5 Chest films11Case of low dose-prorospectively ECG-GatedCPR of LAD12Case of high heart rate-Retrospectively ECG-GatedCPR of LCX and RCA13Reduced Radiation DoseHoe J, Toh KH. J Cardiovasc Comput Tomog. 2009;3:257-261.Prospective 320-slice scanning14High heart

8、rate14Air Propelled Ferry Hovercraft OperationOperationCompressed Air Cushion lifts the ferry above Compressed Air Cushion lifts the ferry above sea level and a conventional motor moves it sea level and a conventional motor moves it forward forward 0.27S 15High heart rateHoe J, Toh KH. J Cardiovasc

9、Comput Tomog. 2009;3:257-261.Scan acquisition parameters with 256-slice MDCTHeart rateExposure controlExposure phase windowData recomstruction mode1782-heart beat scan10% to end of R-R interval4-segment reconstruction0.27S0.35S16Patient Parameters of CT scan Ceng wen,femal,47 years.symptom： discomfo

10、rt in the chest Case of high heart rate-Retrospectively ECG-GatedWeight：55KGHeight：160mm BMI：21.517Case of high heart rate-Retrospectively ECG-GatedCPR of RCA18Case of high heart rate-Retrospectively ECG-GatedMPR of RCA and CT value19Case of high heart rate-Retrospectively ECG-GatedCPR of LADCPR of

11、LCXCPR of DCPR of PDA20Patient Parameters of CT scan Liu hui zhen,femal,57 years.symptom： discomfort in the chest Case of high heart rate-Prospectively ECG-GatedWeight：58KGHeight：164cm BMI：21.621Case of high heart rate-Prospectively ECG-GatedCPR of LCX22Case of high heart rate-Prospectively ECG-Gate

12、dCPR of LCXCPR of LADCPR of MCPR of D+Why?70% cases30% casesDiagnosisCureWhy?30% 70% Diagnosis Cure Thank you for your attention!2009.10.3027Reduced Radiation DoseReported effective radiation dosage in recent studies with the use of 64detector row CT have ranged from 9.5 to 21.4 mSv, more than the p

13、reviously reported d-oses from 16detector row CT studies.James P, Elise L, Bruce A, et al. Prospectively Gated Transverse Coronary CT Angiography versus Retrospectively Gated Helical Technique: Improved Image Quality and Reduced Radiation Dose. Radiology 2008;246:742-75316-detector64-detector256-det

14、ectorMore doseage？More doseage28Patient: CT檢查時(shí)條件設(shè)置檢查時(shí)條件設(shè)置 Xiong shu yan ,woman,46Height:162mm,Weight：52KGBMI：19.8Symptom：chest painRadiation doseCTDIvol* Scan Length*0.0141.4mGy* 11.04*0.014=0.21mSvCase of low dose-Prospectively ECG-Gated5 Chest films29Case of high heart rate-Retrospectively ECG-GatedCPR of LCX and RCA30Patient Parameters of CT scan Ceng wen,fem