双源CT大螺距扫描技术在小儿先天性心脏病诊断的临床应用

发布时间：2018-05-08 03:38

本文选题：体层摄影术 + X线计算机　；参考：《四川大学学报(医学版)》2015年02期

【摘要】：目的探讨二代双源炫速CT大螺距心电门控低剂量扫描方案(Advanced prospective ECGtriggering high pitch dual-source computed tomography,FLASH-DSCT)在小儿先天性心脏病(先心病)诊断中的临床应用价值。方法收集2013年2~6月于我院行CT血管扫描的小儿先心病患者78例,随机分为两组,FLASHDSCT组40例,采用FLASH-DSCT扫描方案;对照组38例,采用常规心电门控螺旋扫描方式。记录两组患者的容积CT剂量指数(CTDIvol)和剂量长度乘积(DLP),并计算有效辐射剂量(ED),由2位经验丰富的放射医师独立诊断并采用5分法对图像质量进行评估,对结果一致性评价采用kappa检验,客观评价两组的对比度噪声比(CNR)。以手术结果或数字减影血管造影(digital substraction angiography,DSA)作为金标准,比较两种扫描方法的诊断价值。结果 FLASH-DSCT组患儿行DSCT低剂量扫描方案的ED为(0.238±0.178)mSv,与对照组ED〔(1.897±1.071)mSv〕差异有统计学意义(P0.05);FLASH-DSCT组图像质量平均评分为(4.22±0.73)分,稍优于对照组〔(3.82±0.61)分〕,但差异无统计学意义,两组图像均符合诊断要求;两组降主动脉和左室CNR差异无统计学意义。FLASH-DSCT组与对照组的敏感度(96.4%vs.97.4%)、特异度(99.8%vs.99.5%)和诊断准确率(99.1%vs.99.0%)差异无统计学意义。结论 FLASH-DSCT可有效地降低婴幼儿患者的辐射剂量,提高图像质量,具有重要的临床应用价值。
[Abstract]:Objective to evaluate the clinical value of advanced prospective ECGtriggering high pitch dual-source computed tomography-flash (FLASH-DSCT) in the diagnosis of congenital heart disease (CHD) in children. Methods Seventy-eight children with congenital heart disease underwent CT angiography in our hospital from February to June 2013 were randomly divided into two groups (40 patients with flash HDSCT and 38 patients with conventional ECG gated spiral scan). The volume CT dose index (CTDIvoll) and the dose length product (DLPX) were recorded in both groups. The effective radiation dose was calculated, and the image quality was evaluated by two experienced radiologists. Kappa test was used to evaluate the consistency of the results, and the contrast noise ratio of the two groups was evaluated objectively. The diagnostic value of the two scanning methods was compared with the results of surgery or digital subtraction angiography (DSAs) as gold standard. Results the Ed of DSCT low-dose scanning regimen in FLASH-DSCT group was 0.238 卤0.178 mSv, which was significantly higher than that in control group (ED((1.897 卤1.071 mSv). The average score of image quality was 4.22 卤0.73 in FLASH-DSCT group, which was slightly better than that in control group (3.82 卤0.61), but the difference was not statistically significant. The CNR of descending aorta and left ventricle were not significantly different between the two groups. The sensitivity of FLASH-DSCT group was 96.4vs.97.4cm, the specificity was 99.8vs.99.5cm) and the diagnostic accuracy was 99.1vs.99.0) there was no significant difference between the two groups. Conclusion FLASH-DSCT can effectively reduce the radiation dose of infant patients and improve the image quality.
【作者单位】：四川大学华西医院放射科;
【分类号】：R725.4;R816.92

【共引文献】