双定位像在降低肺动脉CTA辐射剂量的临床应用价值  

The Clinical Value of CT with Both Anteroposterior and Lateral Topograms in Pulmonary CT Angiography Using CARE Dose 4D and CARE kV

作　　者：赵飞[1] 李磊[1] 彭婉琳 蒲进[1] 张凯[1] 刘科伶 李玉明[1] 张金戈[1] 夏春潮[1] 李真林[1] ZHAO Fei;LI Lei;PENG Wanlin(Radiology Department,West China Hospital Sichuan University,Chengdu 610041,P.R.China)

机构地区：[1]四川大学华西医院放射科

出　　处：《临床放射学杂志》2018年第12期2108-2111,共4页Journal of Clinical Radiology

摘　　要：目的探讨在CARE Dose 4D和CARE kV技术下,双定位像在肺动脉CT血管造影(CTA)成像应用的可行性及其辐射剂量。方法搜集本院行肺动脉CTA检查的患者60例,按抽签法随机分为对照组和实验组,每组各30例,在CARE Dose 4D和CARE kV技术下,对照组行单定位像(AP)扫描,实验组行双定位像(AP和lat)扫描。由两位高年资放射医师采用双盲法对两组患者肺动脉图像的信噪比(SNR)、对比噪声比(CNR)及其整体图像质量进行分析和评价,同时记录其辐射剂量。结果 60例患者均成功完成肺动脉CTA检查,对照组整体图像质量与实验组整体图像质量差异无统计学意义(t=1.439,P > 0.05)。对照组图像SNR(33.29±20.41)、CNR(28.17±11.76)与实验组图像SNR(33.79±20.48)、CNR(28.34±11.03)差异均无统计学意义(P均 > 0.05)。实验组的CT容积剂量指数(CTDIvol)为(5.82±0.97)m Gy,剂量长度乘积(DLP)为(189.85±34.78)m Gy·cm,有效辐射剂量(ED)(2.66±0.49)m Sv较对照组CTDIvol(6.99±1.35)m Gy,DLP(245.73±48.92)m Gy·cm,ED(3.44±0.68)m Sv均降低了29.43%(P均<0.001)。结论在CARE Dose 4D和CARE kV技术下,较单定位像肺动脉CTA检查,双定位像肺动脉CTA检查可获得满足诊断及临床需求图像,同时明显降低辐射剂量,可成为临床肺动脉CTA常规检查方式。Objective To investigate the feasibility and clinical value of anteroposterior and lateral scout scan combined with CARE Dose 4D and CARE k V in Pulmonary CTA.MethodsA total of 60 patients were enrolled.Those patients were randomly divided into test group and control group.Control group underwent a scan protocol with lateral scout scan combined with CARE Dose 4D and CARE k V,while anteroposterior and lateral scout scan combined with CARE Dose 4D and CARE k V were performed in test group.The signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and overall image quality of two groups of images were analyzed and evaluated by two high-grade radiologists using double-blind method.Effective doses(EDs)were also calculated.ResultsAll the 60 patients had successfully completed the chest CT scans.Averages of subjective image quality、SNR and CNR of arterial phase were(4.63±0.49)、(33.29±20.41)、(28.17±11.76)in control group and(4.57±0.57)、(33.79±20.48)、(28.34±11.03)in test group,respectively.There was no statistically significant difference between two groups in subjective and objective image quality(t=1.439、0.369、1.85,P >0.05).Averages of CTDIvol、DLP、ED in control group were(6.99±1.35)m Gy、(245.73±48.92)m Gy·cm、(3.44±0.68)m Sv and(5.82±0.97)m Gy、(189.85±34.78)m Gy·cm、(2.66±0.49)m Sv in test group.Compared with control group,the averages of CTDIvol、DLP、ED decreased by 29.43%in test group,with statistically significant difference(t=8.514、8.464、8.464,P<0.001).ConclusionCompared with anteroposterior scout scan,the technology of anteroposterior and lateral scout scan combined with CARE Dose 4D and CARE k V can decrease radiation dose without reducing the image quality.This technology can therefore be considered as a regular imaging modality for Pulmonary CTA scan.

关 键 词：肺动脉 辐射剂量 CARE DOSE 4D CARE KV 定位像 

分 类 号：R816.2[医药卫生—放射医学] R563.5[医药卫生—临床医学]