成人腕关节CT检查中的低剂量扫描条件优化

发布时间：2018-05-03 08:41

本文选题：腕关节 + 多层螺旋CT　；参考：《广东医学》2015年09期

【摘要】：目的探讨64层螺旋CT在腕关节低剂量扫描中的最佳条件和可行性及其临床价值。方法将60例常规X线检查阴性,而临床高度怀疑骨折及其他病变的患者行64层螺旋CT作常规剂量和低剂量扫描,分为3组,低剂量A组扫描条件120 k V/60 m As,低剂量B组扫描条件100 k V/40 m As,对照组扫描条件120 k V/100 m As。对所得原始数据进行重建处理后,分析3组扫描图像质量、诊断准确率的差异以及辐射剂量高低等各数据。结果对照组、低剂量A组、低剂量B组CT剂量指数分别为(5.48±0.35)、(3.20±0.26)、(1.33±0.16)m Gy,剂量长度乘积分别为88.1±2.6、56.0±1.3、23.4±1.5,主观评分为4.70±0.65、4.12±0.93、3.39±0.57。低剂量组与对照组比较、两低剂量组组间比较主客观CT图像质量评分差异有统计学意义(P0.05)。低剂量A组、低剂量B组较对照组图像,在骨质、软组织、伪影及三维重建方面等主观分略有下降,但是得分均值在3分以上,同时辐射剂量较对照组明显下降。结论当扫描条件降至100 k V/40 m As,随着患者剂量下降,主观评分下降,但低剂量下的图像重建(VR、MPR)所得三维图像仍能较好显示解剖关系,能准确显示腕关节创伤空间信息,符合临床需要,同时降低了患者的辐射剂量并保护了患者。
[Abstract]:Objective to investigate the optimal condition, feasibility and clinical value of 64-slice spiral CT in low-dose scan of wrist joint. Methods Sixty patients with negative routine X-ray examination and highly suspected fracture and other lesions were divided into 3 groups. The scanning conditions of low dose A group were 120 kV / 60 m as, low dose B group 100 kV / 40 m Asand control group 120 kV / 100 m As. After the original data were reconstructed, the quality of three groups of scanning images, the difference of diagnostic accuracy and the radiation dose were analyzed. Results the CT dose index of control group, low dose A group and low dose B group were 5.48 卤0.35, 3.20 卤0.26 and 1.33 卤0.16 mGy, respectively. The dose length product was 88.1 卤2.6 ~ 56.0 卤1.3 卤23.4 卤1.5, and the subjective score was 4.70 卤0.654.12 卤0.933.39 卤0.57. The difference of subjective and objective CT image quality score between the low dose group and the control group was statistically significant (P 0.05). The subjective scores of bone, soft tissue, artifact and 3D reconstruction in low dose group A and low dose group B were slightly lower than those in control group, but the average score was more than 3 points, and the radiation dose was significantly lower than that in control group. Conclusion when the scanning condition is reduced to 100 kV / 40 m as, the subjective score decreases with the decrease of the dose of the patient, but the 3D images obtained from the low dose image reconstruction can still display the anatomical relationship well, and can accurately display the spatial information of wrist trauma. Meets the clinical needs, simultaneously reduces the patient's radiation dose and protects the patient.
【作者单位】：上海交通大学医学院附属新华医院崇明分院放射科;
【分类号】：R816.8

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