重症和危重症新型冠状病毒肺炎患者床旁DR图像质量控制  

Quality control of bedside DR images in severe and critical patients with corona virus disease 2019

作　　者：岑人丽[1] 钱元新[1] 李林[1] 李倩仪 郑叔宏 曾庆思[1] 陈淮[1] 刘晨 宋玉全[1] CEN Ren-li;QIAN Yuan-xin;LI Lin;LI Qian-yi;ZHENG Shu-hong;ZENG Qing-si;CHEN Huai;LIU Chen;SONG Yu-quan(Department of Radiology,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,Guangdong,China)

机构地区：[1]广州医科大学附属第一医院放射科,广东广州510120

出　　处：《生物医学工程与临床》2020年第6期678-681,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨提高重症和危重症新型冠状病毒肺炎(COVID-19)患者床旁数字化X射线摄影术(DR)胸部影像图像质量的方法。方法按检查时间顺序选择广州医科大学附属第一医院2020年1月27日至2月26日COVID-19重症和危重症患者16例,其中男性14例,女性2例;年龄26~79岁,中位年龄61岁。所有患者均行床旁DR胸片检查,共129次胸部DR,以是否采取质量控制措施为时间节点,将所有照片分为质控组和非质控组。质量控制措施包括:①专人投照;②对投照技师进行思想和COVID-19有关知识培训;③根据COVID-19病程特点对摄影条件进行调整。对两组胸部图像质量进行对比分析。结果共129幅胸部影像,其中质控组79幅,非质控组50幅。质控组甲级片率为93.67%,乙级片率为6.33%,丙级片率为0%,废片率为0%;非质控组甲级片率为68.00%,乙级片率为30.00%,丙级片率为2.00%,废片率为0%。两组图像的甲级片率差异有显著统计学意义(P<0.001)。图像质量欠佳的主要原因是体位不正、摄影条件欠佳。结论通过质量控制措施,明显提高了重症和危重症COVID-19患者DR床旁照片的影像质量。在二级防护条件下对重症和危重症COVID-19进行投照采取质量控制措施非常必要。Objective To improve image quality of bedside digital radiography(DR)in severe and critical patients with corona virus disease 2019(COVID-19).Methods From January 27 to February 26 in 2020,a total of 16 severe and critical COVID-19 patients were enrolled,which included 14 males and 2 females,aged 26-79 years old with median age of 61 years old.All of them underwent bedside DR chest X-ray.The 129 chest DR images were divided into quality control group and nonquality control group according to whether quality control measures were taken.The quality control measures included:①specialized photo shooting;②conducted training on thought and COVID-19 related knowledge for photo technician;③adjusted photography conditions with characteristics of COVID-19 course.The comparative analysis of chest image quality between 2 groups were performed.Results There were 129 chest radiography,79 of which in quality control group and 50 in non-quality control group.In quality control group,film rate of grade A was 93.67%,grade B was 6.33%,grade C was 0%,and waste rate was 0%.In non-quality control group,grade A was 68.00%,grade B was 30.00%,grade C was 2.00%,and waste rate was 0%.The difference in grade A film rate between 2 groups was statistically significant(P<0.001).The main reasons for poor image quality were improper posture and poor photography conditions.Conclusion It is demonstrated that quality control significantly improve the image quality of DR bedside photos of critically ill and critically patients with COVID,so which is very necessary to perform quality control shots at secondary protection conditions.

关 键 词：新型冠状病毒肺炎(COVID-19) X射线摄影技术 床旁DR 胸部影像 图像质量 

分 类 号：R563.14[医药卫生—呼吸系统] R816.4[医药卫生—内科学]