双源CT70kV管电压在颈动脉系统短暂性脑缺血发作一站式检查中的临床价值  

Clinical value of dual-source CT 70 kV tube voltage in one-stop examination of carotid system transient ischemic attack

作　　者：郑玉劲[1] 聂吉琰 梁辉清 郑穗敏[1] 周源勇 吴庆德[1] 何旭霞 罗少勇 ZHENG Yujin;NIE Jiyan;LIANG Huiqing;ZHENG Suimin;ZHOU Yuanyong;WU Qingde;HE Xuxia;LUO Shaoyong(Department of Radiology,Shunde Hospital of Guangzhou University of Chinese Medicine,Shunde,Guangdong Province 528333,China)

机构地区：[1]广州中医药大学顺德医院放射科,广东顺德528333

出　　处：《实用放射学杂志》2023年第4期522-525,共4页Journal of Practical Radiology

基　　金：佛山市卫生健康局医学科研课题(20210381)。

摘　　要：目的探讨双源CT70kV管电压对颅脑CT灌注成像(CTP)、头颈部CT血管成像(CTA)一站式检查时图像质量、辐射剂量的影响,及在颈动脉系统短暂性脑缺血发作(TIA)中的诊断价值。方法选取100例临床诊断为TIA的患者随机分为2组,均在发病24h内用双源CT依次行CTP、CTA检查。研究组50例,70kV管电压;常规组50例,80kV管电压行CTP检查、100kV管电压行CTA检查,评价2组颅脑CTP伪彩图、头颈部CTA的图像质量,记录有效剂量(ED)及统计TIA患者CTP、CTA阳性率。结果2组CTP伪彩图、头颈部CTA质量评分差异均无统计学意义(P>0.05),均符合诊断要求。2组CTP及CTA的容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP)、ED差异均有统计学意义(P<0.05),研究组CTP、CTA总的ED较常规组下降了34%,其中CTP的ED为2.5mSv,较常规组的3.1mSv减少了19%,研究组CTA的ED为(0.31±0.03)mSv,较常规组的(1.19±0.19)mSv减少74%。2组病例中CTP显示与临床症状相对应异常灌注区高达80%(80/100),CTA检查阳性率79%(79/100)。结论双源CT70kV管电压能显著降低颅脑CTP、头颈部CTA一站式检查时患者的辐射剂量,并能显示出TIA责任区脑组织的低灌注状态及造成脑组织低灌注的责任颈动脉系统血管病变,为临床明确诊断及指导治疗提供重要依据。Objective To investigate the effect of dual-source CT 70 kV tube voltage on image quality and radiation dose of cranial computed tomography perfusion(CTP)and head and neck computed tomography angiography(CTA),and its clinical value in transient ischemic attack(TIA)of carotid system.Methods A total of 10O patients with TIA were randomly divided into two groups.CTP and CTA were performed successively with dual-source CT within 24 hours of onset.50 cases in the study group,70 kV tube voltage;50 cases in the conventional group were examined by CTP with 80 kV tube voltage and CTA with 100 kV tube voltage.The image quality of cranial CTP pseudo-color map and head and neck CTA in the two groups were evaluated,the effective dose(ED)was recorded and the positive rates of CTP and CTA in patients with TIA were counted.Results There were no significant differences in the pseudo-color map of CTP and CTA quality score of head and neck between the two groups(P>0.O5),which met the diagnostic requirements.The volume CT dose index(CTDIvol),dose length product(DLP)and ED of CTP and CTA in the two groups were statistically significant(P<0.05).The total ED of CTP and CTA in the study group was 34%lower than that in the conventional group,and the ED of CTP was 2.5 mSv,19%lower than that of the conventional group's 3.1 mSv.The ED of CTA in the study group was(0.31±0.03)mSv,74%lower than that in the conventional group(1.19±0.19)mSv.In the two groups,CTP showed up to 80%(80/100)of abnormal perfusion area corresponding to clinical symptoms,and the positive rate of CTA examination was 79%(79/100).Conclusion Dual-source CT 70 kV tube voltage can significantly reduce the radiation dose of patients during one-stop examination of cranial CTP and head and neck CTA,and can show the hypoperfusion status of brain tissue in the TIA area of responsibility and the vascular lesion of the responsible carotid system that causes hypoperfusion of brain tissue,providing an important basis for clinical diagnosis and guidance of treatment.

关 键 词：短暂性脑缺血发作 有效剂量 计算机体层成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]