雙射源電腦斷層掃描儀以手動控制取樣影像重組技術於高心律與心律不整之應用

Application of Cardiac Arrhythmia and High Heartbeats Image Acquisition and Reconstruction in Dual Source Computed Tomography

林鼎裕(Tin-Yu Lin) ； 白坤海(Kun-Hai Pai) ； 惲純和(Chun-Ho Yun) ； 楊斐適(Fei-Shish Yang) ； 杜俊元(Chen-Yuan Tu)

《中華放射線技術學雜誌》 34卷3期 (2010/09) Pp. 213-219

https://doi.org/10.30045/CJRT.201009.0010

摘要

由於電腦斷層設備儀器的進步，冠狀動脈電腦斷層檢查已成為普遍性的檢查，針對高心律以及心律不整之受檢患者，仍有極大的限制。而本研究利用雙射源電腦斷層掃描儀配合新的影像重組技術突破高心律以及心律不整之受檢患者限制，在閉氣良好和不服用阻斷劑(β-blocker)的情況下，以手動控制技術，可以得到良好的心臟血管影像。高心律以及心律不整在血管影像自動重組上，容易產生心臟跳動假影、疊影以及影像不連續的情況，最常見是心臟跳動假影、疊影次之，影像不連續是屬於較少發生的情況。這些假影的產生皆會造成影像判讀的困難，利用手動控制取樣重組技術可減少上述假影的產生。本研究將右冠狀動脈、左前降枝以及左迴旋枝針對產生自動控制取樣重組技術在心臟收縮期、舒張期，以心電圖R波為基準之正時間取樣及負時間取樣，所產生的心臟跳動假影、疊影以及影像不連續逐一做影像上的分析與比較。研究結果在高心律以及心律不整的患者中，使用手動控制取樣在右冠狀動脈、左前降枝及左迴旋枝皆可得到良好的影像；而使用不同時期自動控制取樣在右冠狀動脈、左前降枝及左迴旋枝產生假影比率較高。針對高心律以及心律不整使用手動控制影像重組是一項新的影像重組技術，可將影像擷取訊號固定於心臟的舒張時期或收縮時期，可避免病患無法檢查及重檢，亦可降低影像上的假影並提供更清楚的臨床診斷。

關鍵字

冠狀動脈 ； 心律不整 ； 雙射源電腦斷層掃描儀

並列摘要

The advancement of equipment makes coronary artery computed tomography (CT) scanning a general examination. Nevertheless, there is great limit on patients with higher heart rate and arrhythmia. This study used dual source computed tomography (DSCT) together with new image reconstruction technique to break the limit. With manual adjustment techniques, good cardiac blood vessel images can be obtained under breath-holding and without taking β-blocker. It is easy to have heart beat artifact, image overlapping, and image discontinuity when auto-reconstructing blood vessel images for higher heart rate and arrhythmia artifact patients. The most common situation is heart beat artifact, followed by image overlapping, while image discontinuity is the least to occur. The occurrence of these artifacts will all lead to interpretative difficulties. The manual adjustment techniques can reduce the occurrence of the aforementioned artifacts. This study analyzes and compares heart beat artifacts, image overlapping, and image discontinuity produced by positive time sampling and negative time sampling one by one. These samplings were from diastolic, systolic, and cardiogram based on R wave on auto adjusted sampling reconstruction techniques from right coronary artery, left anterior descending artery (LAD), and left circumflex (LCX). Results of the study indicates good images can be obtained on right coronary artery, left anterior descending artery (LAD), and left circumflex (LCX) with manual adjustment techniques for patients with high heart rate and arrhythmia. Artifacts would be higher for auto-adjust sampling in different phases on right coronary artery, left anterior descending artery (LAD), and left circumflex (LCX). Manual adjustment image recombination on high heart rate and arrhythmia is a new image recombination technique. It can fix the extracted image signal on diastolic or systolic phase to avoid un-examinable patients or re-examination. It can also reduce artifacts on images and provides clearer clinical diagnosis.

並列關鍵字

coronary artery ； arrhythmia ； dual source computed tomography scanner