床旁胸部DR在急性心肌梗死疾病中的应用及质控研究  

Application and quality control of bedside chest DR in acute myocardial infarction

作　　者：张信起[1] 张寅丰 宋振虎[1] 王宁[1] 高艳辉 ZHANG Xin-qi;ZHANG Yin-feng;SONG Zhen-hu;WANG Ning;GAO Yan-hui(Departmen of Medical Image,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Preventive Medicine,Hebei Institute of Radiology,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院医学影像科,河北石家庄050000 [2]河北放射医学研究所防护科,河北石家庄050000

出　　处：《河北医科大学学报》2018年第12期1428-1432,1437,共6页Journal of Hebei Medical University

基　　金：河北省科技计划项目(162777277)

摘　　要：目的探讨床旁胸部数字化X线摄影(digital radiography,DR)在急性心肌梗死疾病中的应用及质控措施。方法将100例有DR记录的急性心肌梗死患者分为质控前组和质控后组各50例。质控前组摄影参数93kV/1.6mAs,88kV/2mAs等,随机选择,平静呼吸曝光,照射野设置最大,探测器板置于背部包括胸部,对所得图像简单后处理。质控后组根据患者体型合理选择79～81kV/1mAs、84～85kV/1 mAs、88～89kV/1 mAs和93～96kV/1mAs的曝光参数,采用调节控制超短曝光时间技术,改进曝光模式,让患者处于深吸气后屏气状态下曝光,合理控制照射野,使探测器板平整置于患者背下,通过优化和调整图像后处理参数,找到最佳参数组合,对所得图像进行后处理。结果质控后组各体型患者接受辐射剂量均较质控前组明显降低,尤其是偏瘦型患者接受辐射剂量降低最多,其差异有统计学意义(P<0.05);质控后组图像质量评分较质控前组明显提高,质控后组图像质量评分10分的占80.0%(40/50),不合格片为0,而质控前组图像质量评分10分的只占14.0%(7/50),优质片占24.0%(12/50),不合格片占20.0%(10/50),其差异有统计学意义(P<0.05)。结论通过床旁胸部DR在急性心肌梗死疾病中质控前后的应用比较,质控后床旁胸部DR辐射剂量明显降低,图像质量大幅度提高,值得推广应用。Objective To investigate the application and quality control measures of bedside chest digital radiography（DR）in acute myocardial infarction.Methods A total of 100 patients with acute myocardial infarction and photographic parameters were equally divided into no-quality control group and quality control group.The photographic parameters of the no-quality control group were 93 kV/1.6 mAs,88 kV/2 mAs,etc.,randomly selected.Exposure in eupnea,the exposure field was set to the maximum,the flat panel detector was placed on the back including the chest,and the received image was simply processed.The quality control group,the exposure parameters of 79-81 kV/1 mAs,84-85 kV/1 mAs,88-89 kV/1 mAs and 93-96 kV/1 mAs were selected according to the lean,medium,fat and obese body types.The technology of adjusting and controlling ultrashort exposure time was used to improve the exposure mode.The patients were exposed in breath-holding state after deep inhalation.The irradiation field was controlled reasonably.The detector plate was placed flat under the patient′s back.By optimizing and adjusting the parameters of image post-processing,the best combination of parameters was found and the obtained image was post-processed.Results The radiation doses received by patients of each body type in quality control group were significantly lower than those of the noquality control group.Especially lean patients receive the most radiation dose.The difference between the two groups was statistically significant（P〈0.05）.The image quality of the quality control group was significantly higher than the no-quality control group.The first film rate（scores 10）is 80.0%（40/50）.The unqualified film is 0,while the no-quality control group,the first film rate（scores 10）is only 14.0%（7/50）,the top quality film accounts for 24.0%（12/50）,the unqualified film is 20.0%（10/50）,The difference scores between the two groups was statistically significant（P〈0.05）.Conclusion The two methods were compared,after quality contr

关 键 词：心肌梗死 放射摄影术 辐射剂量 

分 类 号：R542.22[医药卫生—心血管疾病]