| Background and Objective: Atherosclerosis(AS)is a very common disease in the clinic and is a systemic disease that occurs in blood vessels and their branches,especially in the coronary,carotid and abdominal Vascular atherosclerosis and plaque formation,which have a common risk factor,although these risk factors may have different effects on different vascular beds,but in clinical work many patients concurrent with multiple parts of the plaque often occur in the daily Assessment of carotid or vertebral atherosclerotic diseases including Doppler ultrasound,magnetic resonance angiography(MRA),computed tomography angiography(CTA),and conventional digital subtraction angiography(DSA)Patients need to evaluate both coronary artery stenosis and carotid and cerebral artery plaque patients,a variety of inspection methods to repeat the examination,in particular,CT examination of the repeat,that is,increased the patient's medical costs and increased the patient's radiation dose,with the CT The progress of the technology,especially the advent of 640 volumetric CT,and the evaluation of the carotid artery,the cerebral arteries and the coronary arteries have become possible.In this study,the use of 640-slice CT scan of low dose,large pitch and other advantages of carotid and cerebral arteries And coronary angiography in one-stop imaging,the initial study of the combined image quality and the patient received radiation dose.Materials and Methods: The CTA was collected from 60 patients in Suzhou Kowloon Hospital,January 2015,January 20,2006,in which the coronary artery,carotid artery and cerebral artery were combined with 20 cases(group 1)Twenty patients(2 groups)with coronary artery CTA were randomly divided into two groups: normal cervical-cerebrovascular CTA(group 3),all patients underwent proactive gating,and the patients were treated with ascending aorta root,bilateral common carotid artery,CT images of the internal carotid artery and image noise.The coronary artery images were evaluated by 4-point method.The cervical-cerebrovascular images were evaluated by 3-point method.The radiation dose of each group was recorded.The CT values and noise of the images between the groups were compared by t-test.The image quality and cardio-cerebral angiography were compared between the coronary artery images obtained by combined cardiovascular and cerebrovascular imaging and the CTA group.The quality of all CTA vascular images was assessed by two independent radiologists,and the kappa test was used to determine the quality of the two images of the two-dimensional physician.K = 0.21-0.80: good consensus;k = 0.41-0.60: medium consensus;k = 0.21-0.40: general agreement;kappa <0.20: bad consensus).Results: There was no significant difference in CT value between the first and second groups(534 ± 58,579 ± 69HU)and the noise(24 ± 9,29 ± 6HU),respectively.There was no significant difference(t value)-1.458,P = 0.148,0.071).The quality of coronary artery segment in group 1 and group 2 was 97.5%(235/241),98.4%(256/260)There was no significant difference in the quality of coronary artery between the two groups(Z = 1.07,P = 0.859,P> 0.05).The CT value of the common carotid artery in group 1 and group 3 was 475 ± 37(25 ± 6,39 ± 12HU)were statistically significant(t = 18.786,-12.998,P = 0.000,P <0.05),and vertebral There were statistically significant differences in the CT values of the arterial initiation(485 ± 24,(367 ± 91HU)and(35 ± 14,25 ± 8HU)respectively(t = 11.821,9.205,P(346 ± 54),(357 ± 36HU),respectively,and the noise was(21 ± 9,27 ± 5HU),the difference was not statistically significant(P <0.05)(468 ± 34)and(446 ± 49HU)in the middle cerebral artery of the middle cerebral artery were significantly higher than those in the control group(P <0.05)(25 ± 11,(27 ± 8),the difference was not statistically significant(t = 1.672,P = 0.103,P> 0.05,t =,-1.126,P = 0.267,p> 0.05),3 groups of cervical cerebrovascular image quality was evaluated as mostly excellent,2 points in 16 cases,3 points in 4 cases;3 groups of 2 points,8 cases,3 points,12 cases,the two groups score difference was statistically significant(3.99 ± 0.37),(3.024 ± 0..32)and(2.35 ± 0.60)m Sv,respectively.The effective radiation doses were(3.99 ± 0.37),(3.024 ± 0..32)and(2.35 ± 0.60)m Sv,;respectively,and the two groups were significantly higher than those in the control group(P <0.05)Radiation physician evaluation consistency kappa = 0.71.Conclusion: The low-dose "one-stop" large-distance cardiovascular and cerebrovascular co-imaging of 640-slice CT can provide images of coronary and cervical-cerebrovascular images that meet the clinical needs.The study was performed to meet the diagnostic needs of coronary artery images 97.5%,The cervical-cerebrovascular image did not show an image that could not be diagnosed.The effective radiation exposure dose of the cardio-cerebral angiography was only 3.99 ± 0.37 m Sv,and the radiation exposure dose was within the reasonable range acceptable to the patient,Line CTA examination,once for clinical treatment to provide more information,is a simple,fast,noninvasive,contrast agent use less,low radiation dose,objective and repeatability of the inspection.value. |
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