第3代双源CT能谱纯化技术在儿童胸部CT检查中的可行性

发布时间：2018-07-01 15:00

本文选题：能谱纯化技术 + 儿童　；参考：《中国医学科学院学报》2017年01期

【摘要】：目的评估第3代双源CT Sn100 kV与传统100 kV 2种不同管电压扫描方案对儿童胸部CT成像图像质量及辐射剂量的影响,探讨更加合理的儿童肺低剂量扫描参数。方法 2015年12月12日至2016年6月30日在北京协和医院进行胸部平扫的连续45例患儿(研究组),采用第3代双源CT能谱纯化技术扫描,管电压Sn100 kV。影像归档和通信系统中选取45例性别及年龄匹配患儿作为对照组,对照组采用第2代双源CT传统100 kV扫描。比较2种不同扫描技术的辐射剂量、肺窗及纵隔窗图像质量。图像质量评价采用5级评分法。辐射剂量及图像客观噪声组间比较行方差分析及t检验,图像质量评分组间比较行Mann-Whitney U检验,医师对图像诊断一致性检验行Kappa分析。结果研究组的CT容积剂量指数为(0.24±0.11)m Gy,较对照组的(3.10±1.18)m Gy下降了92%(t=16.287,P=0.000);研究组的平均剂量长度乘积和平均有效剂量分别为(7.13±4.72)m Gy·cm和(0.11±0.06)m Sv,明显低于对照组的(84.78±46.78)m Gy·cm(t=11.077,P=0.000)和(1.23±0.61)m Sv(t=12.334,P=0.000)。两组的图像噪声(t=-0.003,P=0.397)和对比噪声比(t=0.545,P=0.488)差异均无统计学意义。两组患者肺窗图像质量评分差异无统计学意义(医师1:U=796.000,P=0.055;医师2:U=889.500,P=0.277);纵隔窗的评分差异有统计学意义(医师1:U=305.000,P=0.000;医师2:U=276.500,P=0.000)。以肺窗为判断标准,研究组的图像质量中位评分为4分(3~5分),对照组为4分(3~5)分,所有图像质量均满足诊断要求。研究组的呼吸运动伪影(χ2=13.846,P=0.001)及心脏搏动伪影(χ2=53.519,P=0.000)均明显低于对照组。结论与传统100 kV扫描技术相比,在儿童胸部CT平扫中采用第3代双源CT能谱纯化技术减低了92%的辐射剂量,同时获得诊断可接受的肺窗图像质量。
[Abstract]:Objective to evaluate the effects of the third generation dual-source CT Sn100kV and traditional 100kV tube voltage scanning schemes on the quality and radiation dose of chest CT images in children, and to explore more reasonable parameters of low-dose lung scanning in children. Methods from December 12, 2015 to June 30, 2016, 45 consecutive children (study group) underwent chest plain scan in Beijing Union Hospital. The third generation dual-source CT energy spectrum purification technique was used to scan the tube voltage of Sn100kV. In the imaging archiving and communication system, 45 children with gender and age matching were selected as the control group, and the control group were treated with the second generation dual source CT conventional 100 kV scan. The radiation dose and image quality of lung window and mediastinal window were compared between two different scanning techniques. The image quality was evaluated by 5 grade scoring method. Variance analysis and t test were performed in the comparison of radiation dose and image objective noise, Mann-Whitney U test was performed in the comparison of image quality score group, and Kappa analysis was performed on the consistency test of image diagnosis. Results the CT volumetric dose index of the study group was (0.24 卤0.11) mGy, which was significantly lower than that of the control group (3.10 卤1.18) mGy) by 92% (t = 16.287mGy 0.000), and the mean dose length product and the mean effective dose of the study group were (7.13 卤4.72) mGy cm and (0.11 卤0.06) mGy vs (84.78 卤46.78) mGy (t11.077mGy) 0.000 and (1.23 卤0.61) mSv (t12.334p0.000), respectively. There was no significant difference between the two groups in image noise (t0. 003) and contrast noise ratio (t-0. 545 ~ 0. 488). There was no significant difference in pulmonary window image quality between the two groups (Doctor 1: U 796.000 P0.055; Doctor 2: U 889. 500 P 0.277), but the mediastinal window score was significantly different (physician 1: U 305.000 P 0.000; physician 2: U 276.500 P 0.000). The median image quality score was 4 (3 ~ 5) in the study group and 4 (3 ~ 5) in the control group. All the images met the diagnostic requirements. The respiratory motion artifact (蠂 ~ 2 ~ 2 ~ (13) 846) and cardiac pulsatile artifact (蠂 ~ (2) in the study group were significantly lower than those in the control group (蠂 ~ (2 +) ~ (53. 519) P ~ (0.000). Conclusion compared with the traditional 100 kV scanning technique, the third generation dual-source CT energy spectrum purification technique can reduce the radiation dose by 92% and obtain the acceptable lung window image quality in the chest CT plain scan of children.
【作者单位】：中国医学科学院北京协和医学院北京协和医院放射科;中国医学科学院北京协和医学院北京协和医院儿科;
【基金】：国家临床重点专科建设项目(2014)~~
【分类号】：R816.92

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