精准体表定位扫描在头颈部CTA检查中的应用价值  

Application value of accurate body surface positioning scanning in head and neck CTA examination

作　　者：梁卡丽 戴贵东 杨琴 LIANG Kali;DAI Guidong;YANG Qin(Department of Radiography,Hospital(T.C.M)Affiliated to Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属中医医院放射影像科,四川泸州646000 [2]西南医科大学附属医院放射科,四川泸州646000

出　　处：《中国中西医结合影像学杂志》2022年第5期411-413,417,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：西南医科大学附属中医医院2018年度科研课题(西南医科大校〔2018〕6号-87)。

摘　　要：目的:探讨双定位像的精准体表定位扫描在头颈部CTA检查中的应用价值。方法:收集行头颈部血管成像的244例成年患者的图像资料,随机分为常规扫描方案组(A组)126例和优化方案组(B组)118例。A组行矢状面单定位像扫描,B组行冠状面、矢状面双定位像扫描。在VR前后正位像上使用2D工具测量颅顶层面至颈部血管起始端下缘层面之间的垂直距离,以及主动脉弓最上缘层面至颈部血管起始端下缘层面的矢状垂直直线距离,分别定义为最佳扫描范围和最佳定位参考范围。实际扫描范围与最佳扫描范围之差定义为扫描误差,分为5级:Ⅰ级,误差<0 mm,提示扫描范围不足,扫描失败;Ⅱ级,误差>0~20 mm(最佳级别);Ⅲ级,误差>20~40 mm;Ⅳ级,误差>40~60 mm;Ⅴ级,误差>60 mm。2组重建视野及扫描误差比较采用t检验,同时统计扫描成功患者中头颈部CTA检查最佳定位参考范围。结果:244例中,234例扫描成功,获得满意图像;10例扫描范围不完整。A组扫描误差为Ⅰ级10例,Ⅱ级40例,Ⅲ级51例,Ⅳ级20例,Ⅴ级5例;B组扫描误差为Ⅱ级108例,Ⅲ级10例。B组扫描最佳级别(Ⅱ级)占91.5%(108/118),远大于A组[31.7%(40/126)];A组扫描成功率为92.1%(116/126),B组为100.0%(118/118)。A组重建视野为(26.67±2.35)cm,B组为(21.25±1.97)cm,2组比较差异无统计学意义(P=0.848)。通过对234例扫描成功患者的VR图像进行测量,A、B组的扫描误差均值分别为(26.47±16.25)mm和(12.43±6.49)mm,2组比较差异有统计学意义(P<0.001)。234例头颈部CTA最佳定位参考范围均值为(18.40±5.95)mm。结论:双定位的头颈部CTA扫描与单定位相比扫描范围更精准,可大大减少扫描误差,降低辐射剂量,提高检查成功率,同时最佳定位参考范围也可作为今后该区域检查定位范围的参考。Objective:To explore the application value of precision scans with dual-scout views in head and neck CTA examination.Methods:A total of 244 patients who underwent head and neck CTA examination were collected and randomly divided into Group A(126 cases with conventional scan)and Group B(118 cases with optimized scan).The patients in Group A were treated with a signal scout view(sagittal),and the patients in Group B were treated with a dual-scout view(sagittal and coronal).The optimum scan range was defined with the vertical distance measured with 2D tools in VR anteroposterior images from the top of the skull to the lower margin of the neck vascular origin,and the optimum reference range of the prescan was defined with the vertical distance measured from the upper margin of the aortic arch to the lower margin of the neck vascular origin.The difference between the actual scan range and optimum scan range was defined with scan deviation.Five grades of evaluation standards of scan deviation included gradeⅠ(<0 mm,insufficient scan range and a scanning failure),gradeⅡ(0~20 mm,the best scan),gradeⅢ(20~40 mm),gradeⅣ(40~60 mm)and gradeⅤ(>60 mm).T-test was used to compare and analyze the reconstructed visual field and scanning error of the two groups of data.Meanwhile,the optimal positioning reference range of head and neck CTA examination in the patients with successful scanning was counted.Results:234 cases were scanned successfully,and 10 failed.The numbers of scan deviations of Group A were 10 for gradeⅠ,40 for gradeⅡ,51 for gradeⅢ,20 for gradeⅣand 5 for gradeⅤ.The numbers of scan deviations of Group B were 108 for gradeⅡand 10 for gradeⅢ.The proportion of best grade(gradeⅡ)in Group B was 91.5%(108/118),which was higher than that in Group A(31.7%,40/126).The scan success rate was 92.1%(116/126)in Group A and 100.0%(118/118)in Group B.The reconstructed visual field was(26.67±2.35)cm in Group A and(21.25±1.97)cm in Group B,and there was no significant difference.The scan range deviations of Gr

关 键 词：体层摄影术 X线计算机 血管造影术 精准影像扫描 头颈部 双定位 

分 类 号：R816.1[医药卫生—放射医学]