SPECT／CT显像致患者有效剂量的初步探讨  

Preliminary study on effective dose of patients in SPECT/CT fusion imaging

作　　者：刘雪辉[1] 李洪均[1] 于鸿煦 周爽[1] 楼明[1] 

机构地区：[1]天津市第三中心医院核医学科,300170

出　　处：《中华核医学与分子影像杂志》2015年第5期387-390,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的评估SPECT／CT同机融合显像所致患者有效剂量。方法回顾性研究2013年4月至2014年9月157例接受SPECT／CT检查的患者，男85例，女72例，年龄24-88（60．46±13．44）岁；其中。99^Tc^m-MDP骨显像组113例，99^Tc^m-MIBI甲状旁腺显像组23例，99^Tc^m-MAA肺血流灌注显像组21例。记录注入患者体内的放射性核素活度（MBq），应用国际辐射防护委员会（ICRP）推荐公式计算放射性核素所致有效剂量。记录同机CT检查时CT容积剂量指数（CTDIv01）以及剂量长度乘积（DLP），并根据有效剂量转换因子（K）估算CT检查所致有效剂量。对不同显像组间检查所致有效剂量进行分析，多组间均数比较采用Kruskal—WMlis秩和检验，2组均数比较采用Wilcoxon秩和检验。结果99^Tc^m-MDP骨显像组放射性核素所致有效剂量为（4．02±0．35）mSv、99^Tc^m-MIBI甲状旁腺显像组为（6．13±0．53）mSv、99^Tc^m-MAA肺血流灌注显像组为（1．66±0．13）mSv，差异有统计学意义（x^2=96．853，P〈0．05），两两比较差异均有统计学意义（Z=7．533、7．262和5．676，均P〈0．05）；同机CT检查所致有效剂量分别为（3．84±1．98）、（1．04±0．19）和（4．05±0．47）mSv，差异有统计学意义（x^2=41．225，P〈0．05），甲状旁腺显像组与骨显像组、肺血流灌注显像组差异均有统计学意义（z=6．046和5．672，均P〈0．05）。SPECT／CT检查总有效剂量分别为（7．86±1．98）、（7．17±0．81）和（5．71±0．45）mSv，差异有统计学意义（x^2=28．988，P〈0．05），肺血流灌注显像组与骨显像组、甲状旁腺显像组差异均有统计学意义（Z=4．967和4．994，均P〈0．05）。结论SPECT／CT检查时同机CT扫描可增加患者所受有效剂量，日常使用时应遵循实践正当化及最优化原则。Objective To assess the patient effective dose during SPECT/CT imaging. Methods A total of 157 patients （85 males, 72 females; mean age： （60.46± 13.44） years, range： 24-88 years） who underwent SPECT/CT from April 2013 to September 2014 were retrospectively analyzed. They were divided into 3 groups ： 99^Tc^m-MDP bone scan group （ n = 113 ）, 99^Tc^m-MIBI parathyroid imaging group （ n = 23 ） and 99^Tc^m-MAA pulmonary perfusion imaging group （n= 21 ）. The injection dose （MBq） was recorded and the effective dose （mSv）. was estimated according to the International Commission on Radiologieal Protection （ICRP） guideline. The volume-weighted computed tomography dose index （CTDIvol） and dose length prod- uct （DLP） of CT were also recorded and the effective dose （mSv） due to CT was calculated. The effective doses among different groups were statistically compared by Kruskal-Wallis rank sum test and Wileoxon rank sum test. Results The effective dose from radiopharmaceutieals were （4.02_＋0.35） mSv for 99^Tc^m-MDP bone scan, （6.13±0.53） mSv for 99^Tc^m-MIB1 parathyroid imaging and （1.66~0.13） mSv for 99^Tc^m-MAA pulmonary perfusion imaging （x^2= 96.853; Z= 7.533, 7.262 and 5.676; all P〈0.05）. The effective dose due to CT were （3.84±1.98）, （1.04±0.19）, （4.05±0.47） mSv respectively （x^2=41.225, P〈0.05）, and there were significant differences between 99^Tc^m-MIBI parathyroid imaging group and 99^Tc^m-MDP bone scan group, 99^Tc^m-MAA pulmonary perfusion imaging group（Z= 6.046 and 5.672, both P〈0.05）. The total ef- fective dose during SPECT/CT imaging were （7.86±1.98）, （7.21±0.81） and （5.71±0.45） mSv （x^2 =28.988, P〈0. 05）. There were significant differences between 99Tcm-MAA pulmonary perfusion imaging group and 99^Tc^m-MDP bone scan group, 99^Tc^m-MIBI parathyroid imaging group（Z= 4.967 and 4.994, both P〈0.05 ）. Conclusions The increase in effective dose due to spiral CT during SPECT/CT examination should

关 键 词：辐射剂量 体层摄影术 发射型计算机 单光子 体层摄影术 X线计算机 MDP MIBI MAA 

分 类 号：R817.4[医药卫生—影像医学与核医学]