低管电压联合自适应统计迭代重建算法在儿童鼻窦CT检查中的应用价值  

Application Value of Adaptive Statistical Iterative Reconstruction Algorithm Combined with Low Tube Voltage in CT Diagnosis of Pediatric Paranasal Sinuses

作　　者：朱旭玮[1] 谢宝君[1] 

机构地区：[1]武汉大学人民医院放射科,湖北武汉430060

出　　处：《华南国防医学杂志》2017年第6期376-379,共4页Military Medical Journal of South China

摘　　要：目的探讨低管电压联合自适应统计迭代重建(adaptive statistical iterative reconstruction,ASIR)技术在儿童鼻窦电子计算机断层扫描(computed tomography,CT)检查中的临床应用价值。方法纳入160例接受鼻窦CT检查的患儿为研究对象,根据CT重建方案不同分为常规剂量组和低剂量组,各80例,常规剂量组采用滤波反投影法(filtered back projection,FBP)重组图像,低剂量组采用ASIR图像。由两位放射专家采用5分法独立评价图像质量,组间可靠性采用Kappa检验。比较两组图像噪声、对比噪声比(contrast to noise ratio,CNR)、主观评价及辐射剂量。结果低剂量组CT扫描CT容积剂量指数(CT dose index volume,CTDI_(vol))、剂量长度乘积(dose length production,DLP)及有效辐射剂量(effective radiation dose,ED)值分别较常规剂量组降低50.80%、55.80%和52.40%,组间比较差异具有统计学意义(P<0.05)。2名医师的主观评分结果具有较高一致性(Kappa=0.834,P<0.01)。两组图像主观评分,噪声值,CNR值比较差异均无统计学意义(P均>0.05)。结论采用100kV管电压联合ASIR技术可有效减低儿童鼻窦CT扫描时患儿接受的放射剂量,并且能够保证图像质量符合诊断需要。Objective To explore clinical application value of computed tomography（CT） using low-tube voltage combined with adaptive statistical iterative reconstruction technique （ASIR）for pediatric sinuses. Methods A total of 160 pediatric sinuses patients were enrolled in this study and randomly divided into two groups： conventional group （with fil- tered back-projection reconstruction, 120 kV） and low-dose group （ASIR reconstruction, 100 kV）. Radiation dose and im- age quality between two groups were compared. Two experienced radiologists independently evaluated the image quality with 5-point scores, and interrater reliability was calculated with Kappa analysis. The image noise, contrast to noise ratio （CNR）, subjective evaluation and radiation dose were analyzed statistically. Results CT dose index volume （CTDLol）, dose length produnction （DLP）, effective radiation dose （El）） in low-dose group were lower than those in conventional group （each P〈0. 01）, with decrease of 50. 80%, 55.80% and 52. 40%, respectively. The subjective image quality scores were highly consistent （Kappa= 0. 834, P〈0. 01）. The objective image, noise, CNR score were not statistically different between two groups （P〈0. 05）. Conclusion For pediatric paranasal sinuses, ASIR combined with low-tube voltage allows a significant dose reduction. Meanwhile maintain a good diagnostic image quality and conspicuity of relevant anatomic structures.

关 键 词：电子计算机断层扫描 鼻窦 迭代重建 辐射剂量 图像质量 

分 类 号：R445.2[医药卫生—影像医学与核医学] R765.4[医药卫生—诊断学]