双源CT双低剂量CTU在上尿路梗阻诊断中的可行性研究  

Feasibility study of dual source CT and dual low dose CTU in the diagnosis of upper urinary tract obstruction

作　　者：于洪涛 王伟 曹翼治 陶智慧 王锋 YU Hong⁃tao;WANG Wei;CAO Yi⁃zhi;TAO Zhi⁃hui;WANG Feng(Department of Radiology,Harbin 242 Hospital,Harbin 150066,China)

机构地区：[1]哈尔滨二四二医院放射影像科,黑龙江哈尔滨150066

出　　处：《哈尔滨医科大学学报》2024年第5期539-542,共4页Journal of Harbin Medical University

基　　金：通用医疗科研基金项目(TYYLKYJJ-2023-043)

摘　　要：目的 评价低造影剂用量、低管电压方案双源CT尿路造影(computed tomography urography, CTU)在上尿路梗阻诊断中的应用价值。方法 前瞻性收集哈尔滨二四二医院2023年1月~2024年2月上尿路梗阻患者52例,根据扫描方案不同,分为双低组(L组)及标准组(S组),每组各26例,记录两组的对比剂剂量,计算两组检查的有效辐射剂量;测量双侧肾盂、双侧肾实质、双侧输尿管、膀胱及双侧腰大肌CT值,计算两组图像的信噪比(signal-to-noise ratio, SNR)及对比信噪比(contrast-to-noise ratio, CNR);由两名有丰富腹部影像诊断经验的医师采用双盲法对两组图像进行主观评分。对比分析两组有效剂量、SNR、CNR之间的差异,分析两名影像科医师主观评分的一致性。结果 L组对比剂剂量及有效剂量均明显低于S组(P<0.05)。L组与S组SNR及CNR比较差异无统计学意义(P>0.05)。两名医师主观评分一致性较强。结论 双源CT双低剂量尿路造影所获得图像质量与常规CTU图像质量无显著差异,其在降低造影剂剂量及辐射质量的前提下能够获得满足诊断需求的图像。Objective To evaluate the application value of dual source computed tomography urography(CTU)with low contrast agent dosage and low tube voltage scheme in the diagnosis of upper urinary tract obstruction.Methods Fifty⁃two patients with upper urinary tract ob⁃struction in Harbin 242 Hospital from January 2023 to Febrary 2024 were prospectively collect⁃ed and divided into dual low group(group L)and standard group(group S)based on different scanning protocols,with 26 cases in each group.The contrast agent doses of the two groups were recorded and the effective radiation doses for the two groups were calculated;the CT val⁃ues of bilateral renal pelvis,bilateral renal parenchyma,bilateral ureters,bladder,and bilater⁃al psoas major muscle,and calculate the signal⁃to⁃noise ratio(SNR)and comparative signal⁃to⁃noise ratio(CNR)of the two sets of images were measured;Two physicians with rich experi⁃ence in abdominal imaging diagnosis subjectively scored the two sets of images using a double blind method.The differences in effective dose SNR,CNR between two groups were compared and analyzed,the consistency of subjective scores between two radiologists was analyzed.Re⁃sults The contrast agent dose and effective dose in group L were significantly lower than those in group S(P<0.05).There was no statistically significant difference in SNR and CNR be⁃tween group L and group S(P>0.05).The subjective scores of the two physicians had strong consistency.Conclusion The image quality obtained by dual source CT and dual low dose CTU can meet the diagnostic requirements for upper urinary tract obstruction,and can signifi⁃cantly reduce the contrast agent dose and radiation dose.

关 键 词：上尿路梗阻 CT尿路造影 低剂量 双源CT 体层摄影术 X线计算机 

分 类 号：R445[医药卫生—影像医学与核医学] R695[医药卫生—诊断学]