不同扫描模式在头颈CT血管成像检查中图像质量与辐射剂量的比较研究  

Comparison of the image quality and radiation dose of different scanning modes in head-neck CT angiography

作　　者：张天乐[1] 耿雪 李冬雪 徐艺泽 左紫薇 赵永霞[1] ZHANG Tianle;GENG Xue;LI Dongxue;XU Yize;ZUO Ziwei;ZHAO Yongxia(Department of Radiology,the Affiliated Hospital of Hebei University,Baoding,Hebei Province 071000,China;Department of Radiology,Baoding No.2 Hospital,Baoding,Hebei Province 071051,China)

机构地区：[1]河北大学附属医院放射科,河北保定071000 [2]保定市第二医院放射科,河北保定071051

出　　处：《实用放射学杂志》2021年第10期1702-1706,共5页Journal of Practical Radiology

基　　金：河北省重点科技项目(20377765D);河北省政府资助临床医学重点项目(361007);河北省2020年度医学科学研究课题计划项目(20200572);河北大学医学学科重点培育项目(2021A10);河北大学医学学科培育项目(2021X06);河北大学研究生资助项目(hbu2019ss037);河北大学附属医院重点资助项目(20192004).

摘　　要：目的探讨不同扫描模式在头颈CT血管成像(CTA)检查中图像质量与辐射剂量的比较研究.方法前瞻性连续选取行头颈CTA检查的180例患者按照体质量指数(BMI)分为A组(18.5kg/m^(2)≤BMI<34.9kg/m^(2))和B组(BMI≥34.9kg/m^(2)),每组90例;A组和B组又根据不同扫描方案分为A1、A2、A3,B1、B2、B3亚组,每个亚组30例.A1、B1亚组患者使用常规扫描模式,A2、B2亚组使用kV Assist扫描模式,A3、B3亚组使用宝石能谱成像(GSI)扫描模式.所有患者均采用前置40%和后置70%迭代重建算法对图像进行重建.测量和计算所有图像的动脉CT值平均值、信噪比(SNR)和对比度噪声比(CNR),采用5分法对所有图像进行主观评分,记录各组患者的容积CT剂量指数(CTDIvol),剂量长度乘积(DLP),然后计算有效剂量(ED).分别对6个亚组患者的CT值平均值、SNR、CNR、主观评分和辐射剂量进行单因素方差分析.结果A3、B3亚组患者图像的SNR、CNR及主观评分高于其他亚组(P<0.05);B1和B2亚组中分别有9例和12例的主观评分<3分,B1和B2亚组图像的主观评分值低于其他亚组(P<0.05);A1和A2亚组患者图像的SNR、CNR及主观评分无统计学差异(P>0.05),但A2亚组患者的平均ED较A1组及A3组分别下降41.7%和36.4%.B组中各亚组患者的辐射剂量无统计学差异(P>0.05).结论在头颈CTA检查中,18.5kg/m^(2)≤BMI<34.9kg/m^(2)患者推荐使用kV Assist扫描模式;BMI≥34.9kg/m^(2)患者推荐使用GSI扫描模式.Objective To analyze and compare the image quality and radiation dose of different scanning modes in head-neck CT angiography(CTA).Methods A total of 180 patients who underwent head-neck CTA.The patients were divided into two groups[group A,18.5 kg/m^(2)≤body mass index(BMI)<34.9 kg/m^(2);group B,BMI≥34.9 kg/m^(2)]with 90 patients in each group.The groups were further subdivided according to different scanning modes:subgroups A1,A2,A3,B1,B2,and B3,with 30 patients in each subgroup.Subgroups Al and Bl underwent the conventional scanning modes;subgroups A2 and B2 underwent the kV Assist scanning modes;subgroups A3 and B3 underwent the gemstone spectral imaging(GSI)scanning modes.All images were reconstructed with 40%pre-ASIR and 70% post-ASIR.The mean arterial CT value,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of all images were measured and calculated.All images were scored subjectively by 5-point method.The volume CT dose index(CTDIVO|)and dose-length product(DLP)were recorded,and the effective dose(ED)was calculated.The mean CT value,SNR,CNR,subjective score and radiation dose of the six subgroups were analyzed by one-way ANOVA.Results The SNR,CNR,and subjective score of subgroups A3 and B3 were higher than the other subgroups(P<0.05).In subgroups Bl and B2,the subjective score of 9 patients and 12 patients were lower than 3,respectively.The subjective score of subgroups Bl and B2 were lower than the other subgroups(P<0.05).There was no statistically significant difference in SNR,CNR,and subjective score between subgroups Al and A2(P>0.05).The mean ED of subgroup A2 was 41.7%and 36.4%lower than that in subgroups Al and A3,respectively.In group B,there were no statisticelly significant differences in radiation dose(P>10.05).Conclhsion In the head nck CTA.the kV Assist scanuning mode is recomumendedfor patients wih lMll of 18.5 kg/m^(2)≤BMI<31.9 kg/m;CiSl seanning mode is rcommended for patients with lBMl of≥34.9 kg/m^(2).

关 键 词：扫描模式 头颈 计算机体层成像 血管造影术 图像质量 辐射剂量 

分 类 号：R816.1[医药卫生—放射医学] R814.42[医药卫生—临床医学]