阻塞性睡眠呼吸暂停低通气综合征上气道螺旋CT低剂量扫描的研究

发布时间：2018-02-02 18:34

本文关键词： 上气道辐射剂量 X线断层摄影术　出处：《中华全科医学》2016年09期 　论文类型：期刊论文

【摘要】：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)上气道螺旋CT低剂量扫描的临床价值。方法将120例OSAHS患者采用简单随机法均分为实验组和对照组,2组均行上气道平静呼吸、深吸气末、深呼气末、闭口堵鼻深吸气四个呼吸时相扫描。实验组管电流使用低剂量50 m A,对照组常规剂量360 m A。记录2种剂量的容积CT剂量指数(CTDIvol)、剂量长度积(DLP)和有效剂量(effective dose,E)值。在舌体相同位置进行感兴趣区(region of interest,ROI)CT值测量,并记录每组剂量下CT值和标准差(SD)。双盲法主观评价各组图像质量并给予优、良、差分级,相关数据行统计学处理。结果实验组和对照组扫描长度差异无统计学意义(t=7.23,P=0.479),DLP、E值的比较差异有统计学意义(t=108.252,P=0.000),CTDIvol、DLP、E值实验组比对照组降低87.5%。信噪比的比较,实验组SNR值为6.31±1.75,对照组SNR值为10.17±3.13,t=3.19,P=0.006,实验组SNR明显降低。实验组SD值为25.74±2.61,对照组SD值为1.70±0.17,2组噪声比较,实验组噪声明显增大(t=29.022,P0.001)。主观评判对照组图像质量以优为主,实验组图像质量以良为主,仅3例为差级图像,故基本不影响测量和诊断。结论 OSAHS上气道50 m A低剂量CT扫描能够大幅度降低辐射剂量,且不影响上气道的测量与诊断,具有实际临床应用价值。
[Abstract]:Objective to investigate the effect of obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea hypopnea syndrome, OSAHS) the clinical value of low dose spiral CT scan of upper airway. Methods 120 cases of OSAHS patients were randomly divided into experimental group and control group, 2 groups of upper airway calm breathing, deep breathing, deep breath at the end of four closed plug the nose inspiratory respiratory phase scan. The experimental group used 50 m tube current low dose A, CT dose index volume control group conventional dose 360 m A. recorded 2 doses (CTDIvol), dose length product (DLP) and effective dose (effective, dose, E) value. A region of interest in the same position of the tongue (region of interest, ROI) CT measurement, and record each dose of CT value and standard deviation (SD). Double blind method of subjective evaluation of each image quality and give excellent, good, poor grades, the relevant data for statistical analysis. The results of the experimental group and the The control group was no significant difference between scan length (t=7.23, P=0.479, DLP), there was significant difference between E values (t=108.252, P=0.000), CTDIvol, DLP, E value of experimental group was lower than the control group 87.5%. SNR, SNR value of experimental group was 6.31 + 1.75, SNR = 10.17 + group 3.13, compared with t=3.19, P=0.006, SNR in the experimental group. The experimental group significantly decreased the value of SD was 25.74 + 2.61, 1.70 + 0.17,2 group compared to the control group SD noise value, the experimental group increased significantly (t=29.022, P0.001 noise). The control group as the subjective judgment to excellent quality, good image quality in the experimental group, only 3 cases of poor image, so does not affect the measurement and diagnosis of OSAHS. Conclusion low dose CT scanning 50 m airway A can significantly reduce the radiation dose, and does not affect the measurement and diagnosis of upper airway, has practical value in clinical application.

【作者单位】：温州医科大学附属第二医院放射科;苍南县人民医院放射科;
【基金】：浙江省温州市科技计划项目(Y20130332)
【分类号】：R766;R816.96
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