调整扫描速度确保核素骨显像质量的方法研究

发布时间：2018-07-27 15:28

【摘要】：核素全身骨显像是临床核医学常规检查的最重要项目，约占核医学单光子显像的一半以上，但骨显像的质量参差不齐，多数医院以固定的扫描速度完成所有全身骨显像检查，致使注射剂量较低或体型较重的患者难以获得满意的显像效果，直接影响了临床诊断质量，如何保证全身骨显像质量？美国核医学协会的骨显像指南建议全身骨显像总计数应大于1.5M，但已完成显像，，对于获得高质量骨显像无检查前的指导作用。临床已有人提出在受检者胸部获得预置计数并计算相应的扫描速度，但二者的关系及最终获得的满意显像效果的研究至今未见报道，使这一常规工作似难以科学规范地保证质量。为此，本文通过一系列全身骨显像研究，提出由预置计数确定骨显像的扫描速度，以期获得稳定的高质量全身骨显像结果。本文的第一章为绪论，主要介绍了全身骨显像及其应用，调整扫描速度确保核素骨显像质量研究背景以及本文的主要内容。本文的第二章主要分析比较了骨显像图像质量与总计数之间的关系，通过5名医师对263张骨显像图像的综合评定，并使用统计学非参数检验(Kruskal-Wallis Test)和秩转换的多重比较法(Dunnett’s t Tests)比较不同质量图片的总计数差异，以及确定临床上能保证骨显像质量的总计数值。第三章主要研究了同一患者，在预置计数确定的情况下，总计数与扫描速度之间的关系，即确定患者以不同扫描速度采集时，其总计数的变化规律。第四章则研究了在扫描速度确定的情况下，预置计数与总计数之间的关系。其中我们根据临床常用值采取200mm/min为固定采集速度，研究在200mm/min的采集速度下，患者的预置计数与总计数之间的关系。第五章通过第三、第四章的研究确定如何利用预置计数来计算不同的扫描速度。第六章对第五章确定的方法进行临床上的验证，以确定该方法是否适用于临床，这种用预置计数确定扫描速度的方法是否真正有临床上的指导意义。通过以上一系列实验，我们对临床上如何实现通过调整扫描速度确保核素骨显像质量的方法有了一定程度的了解，作者相信，通过这一骨显像方法的改进，我们在临床工作中能获得更高质量的图像，使全身骨显像的检查质量更加稳定。
[Abstract]:The radionuclide whole body bone imaging is the most important item in the routine examination of clinical nuclear medicine. It accounts for more than half of the single photon imaging of nuclear medicine, but the quality of the bone imaging is not uniform. Most hospitals complete all the whole body bone imaging at a fixed scanning rate. It is difficult for patients with lower injection dose or heavier body size to obtain satisfactory imaging effect, which directly affects the quality of clinical diagnosis. How to ensure the quality of whole body bone imaging? The bone imaging guidelines of the American Association of Nuclear Medicine recommend that the total number of bone scintigraphy should be greater than 1.5 m, but that the imaging has been completed and has no preemptive guidance for obtaining high quality bone scintigraphy. It has been proposed to get a preset count in the chest of the patient and calculate the scanning speed. However, the relationship between the two and the final satisfactory imaging effect has not been reported. It seems difficult to ensure the quality of this routine work in a scientific and normative way. Therefore, through a series of bone imaging studies, the authors put forward that the scanning speed of bone imaging can be determined by preset counting, in order to obtain stable results of high quality whole body bone imaging. The first chapter is the introduction, which mainly introduces the whole body bone imaging and its application, adjusts the scanning speed to ensure the quality of the radionuclide bone imaging and the main content of this paper. In the second chapter, the relationship between the image quality and the total number of bone images was analyzed and compared. 263 bone imaging images were evaluated by 5 physicians. Statistical nonparametric test (Kruskal-Wallis Test) and rank conversion (Dunnett's t Tests) were used to compare the total count difference of different mass images and to determine the total value of bone imaging quality. The third chapter mainly studies the relationship between the total number and the scanning speed of the same patient when the preset count is determined, that is to say, determine the law of the change of the total count when the patient collects with different scanning speed. In chapter 4, we study the relationship between the preset count and the total number when the scanning speed is determined. According to the common clinical values, we take 200mm/min as the fixed acquisition speed, and study the relationship between the patient's preset count and the total number under the 200mm/min acquisition speed. Chapter 5 studies how to use preset count to calculate different scanning speed. In chapter 6, the method determined in chapter 5 is validated in clinic to determine whether the method is suitable for clinical use, and whether the method of determining scanning speed by preset count is of clinical significance. Through the above series of experiments, we have a certain degree of understanding of how to ensure the quality of radionuclide bone imaging by adjusting the scanning speed. The authors believe that through the improvement of this bone imaging method, We can obtain higher quality images in clinical work and make the quality of whole body bone scintigraphy more stable.
【学位授予单位】：上海交通大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R817.4

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