低剂量全脑CTP评价脑血流动力学改变的可行性  

Feasibility Analysis of Low Dose Whole Brain CT Perfusion Imaging to Evaluate the Change of Cerebral Hemodynamics

作　　者：朱杰[1,2] 张蓓[1] 宋彬 王浩 魏冉 翁迎峰 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,200025 [2]上海市闵行区中心医院放射科,201199 [3]上海市闵行区中心医院神经内科,201199

出　　处：《临床放射学杂志》2015年第11期1827-1831,共5页Journal of Clinical Radiology

摘　　要：目的比较不同管电压、管电流条件下全脑CT灌注(CTP)扫描图像质量及灌注参数,探讨低剂量全脑CTP评价脑血流动力学改变的可行性。方法选取行全脑CTP检查患者150例,随机分为3组,A组80 k V、120m As,B组70 k V、120 m As,C组70 k V、100 m As。以全脑CTP基本正常或一侧灌注正常为入组标准,记录3组有效辐射剂量(E)及符合标准的病例数,在正常侧尾状核、丘脑、额叶白质、颞叶白质、枕叶白质、顶叶白质、额叶皮质、颞叶皮质、枕叶皮质和顶叶皮质分别划定感兴趣区(ROI),测量脑灌注参数(CBF、CBV、TTP、MTT)及图像质量信噪比(SNR),应用统计学单因素方差分析比较三组间各脑灌注参数及SNR之间的差异。结果 3组有效辐射剂量分别为A组2.6334 m Sv,B组1.6464 m Sv,C组1.3797 m Sv,B组较A组降低37.48%,C组较B组降低16.2%,C组较A组降低47.61%。3组各ROI测得的脑灌注参数间差异均无统计学意义(P>0.05),三组各脑灌注参数间两两比较差异亦无统计学意义(P>0.05)。3组测得的大脑中动脉起始段SNR之间差异无统计学意义(P=0.45)。结论用70 k V、100 m As行全脑CTP,能显著降低有效辐射剂量,同时脑灌注参数及图像质量没有发生显著变化。Objective To explore the feasibility of low dose whole brain CT perfusion imaging（CTP） to evaluate the change of cerebral hemodynamies by comparing the image quality and perfusion parameters of whole brain CTP under the condition of different tube voltages and tube currents. Methods A prospective study was conducted on 150 patients, and they were randomly divided into 3 groups, group A （80kV, 120mAs） , group B （70k~, 120mAs） , group C （70 kV, 100mAs ）. The patients with normal cerebral perfusion or normal only one side were enrolled in this study. The effective ra- diation dose （E） and the number of patients were recorded. The cerebral perfusion parameters（CBF, CBV, T＇FP, MTF） and signal to noise ratio （SNR） were measured on the region of interest （ROI） , which were located in the normal side of eaudate nucleus, thalamus, frontal white matter and temporal white matter, occipital white matter, parietal white matter, frontal cortex and temporal cortex, occipital cortex and parietal cortex. The difference of the cerebral perfusion parameters and SNR was compared by using single factor variance analysis. Results The effective radiation dose of the three groups were 2. 6334 mSv （ group A） , 1. 6464mSv （ group B） and 1. 3797 mSv （ group C） respectively. Group B was 37.48% lower than group A, and group C was 16.2% lower than group B, and group C was 47.61% lower than group A. No statis- tically significant difference was found in the three groups of cerebral perfusion parameters （ P 〉 0.05 ） , and there was no statistically significant difference among the three groups respectively （ P 〉 0.05 ）. There was no statistically significant difference in the three groups of SNR of the initial period of middle cerebral artery （ P = 0. 45 ）. Conclusion The whole brain CTP with 70 kV, 100 mAs could significantly reduce the effective radiation dose, meanwhile, the cerebral perfusion parameters and image quality have no significant change.

关 键 词：体层摄影术 X线计算机 低剂量 灌注 有效辐射剂量 

分 类 号：R816.1[医药卫生—放射医学]