基于体型特异性剂量估算值与管电流时间乘积预估儿童头颅CT诊断参考水平的研究  

Research on estimating the diagnostic reference levels of pediatric head CT based on size-specific dose estimation and tube current time production

作　　者：陆洋 张见 刘杰[1] 张朋[1] 边传振 王颖 Lu Yang;Zhang Jian;Liu Jie;Zhang Peng;Bian Chuanzhen;Wang Ying(Department of Radiology,Children's Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属儿童医院放射科,南京210000

出　　处：《中国医学装备》2025年第2期26-30,共5页China Medical Equipment

基　　金：江苏省妇幼保健课题(FYX201918)。

摘　　要：目的:探讨基于体型特异性剂量估算值(SSDE)的儿童头颅CT诊断参考水平(DRL)以及利用管电流时间乘积预估SSDE。方法:回顾性收集2023年1月至2023年12月在南京医科大学附属儿童医院行头颅CT检查的1 259例患儿头颅CT资料,根据患儿年龄将其分为<6个月、6个月至<1岁、1岁至<3岁、3岁至<6岁、6岁至<12岁及≥12岁6组;按照儿童头颅体径分为<12.5、12.5~<14、14~<15、15~<16和≥16cm的5组。分别测量记录不同年龄组头颅CT的容积CT剂量指数(CTDIVOL)、管电流时间乘积(mAs)、左右径(LRD)、感兴趣区域面积(AROI)及CT值(CTROI),计算水当量直径(DW)、转换因子(fH16)及基于DW的SSDE(SSDEDW),统计基于年龄及体型的DRLs分布,回归分析DW与管电流时间乘积(mAs)的相关性,并建立SSDEDW与管电流时间乘积(mAs)的回归模型,采用组内相关系数(ICC)分析其一致性。结果:各年龄组DRLs中CTDIVOL为12.32~21.66 mGy,SSDEDW为13.47~17.83 mGy;各体型组DRL中CTDIVOL为13.52~21.86 mGy,SSDEDW为13.91~17.92 mGy。不同年龄组患儿CTDIVOL的头颅辐射剂量DRL典型值(LDRLs)与SSDEDW偏离比率为-8.54%~21.48%。DW与管电流时间乘积(mAs)的100、120kVp均存在正向强相关(r=0.96、0.89,P<0.001)。SSDEDW的计算值与管电流时间乘积实测值有较强的一致性(ICC=0.98)。结论:在儿童头颅CT诊断中,SSDEDW更能准确反映辐射剂量;通过建立的SSDEDW与管电流时间乘积(mAs)的回归模型,可快速计算SSDEDW以控制辐射剂量。Objective:To explore the diagnostic reference level(DRL)of computed tomography(CT)based on size-specific dose estimate(SSDE)for child's head,and estimate the SSDE by using tube current time production.Methods:The CT data of head of 1259 pediatric patients who underwent CT examination in Children's Hospital of Nanjing Medical University from January 2023 to December 2023 were retrospectively collected.They were divided into six groups according to different ages:<6 months group,6 months to<1 year group,1 to<3 years group,3 to<6 years group,6 to<12 years group,and≥12 years group.Additionally,they were divided into five groups based on body size:<12.5 cm group,12.5 to<14 cm group,14 to<15 cm group,15 to<16 cm group,and≥16 cm group.The volume CT dose index(CTDIVOL),tube current time production(mAs),left and right diameter(LRD),area(AROI)and CT value(CTROI)of region of interest of different age groups were respectively measured and recorded.The water equivalent diameter(DW),conversion factor(f H16)and SSDE based on DW(SSDEDW)were calculated.The DRLs distribution based on age and body size was analyzed by statistic method,and the correlation between DW and mAs was analyzed by regression analysis,and a regression model between SSDEDW and mAs was further established.The intra-group correlation coefficient(ICC)was used to analyze the consistency.Results:In DRLs of various age groups,the CTDIVOL range and SSDEDW range were respectively(12.32 mGy-21.66 mGy)and(13.47 mGy to 17.83 mGy).In the DRL of various body size groups,the CTDIVOL range and SSDEDW range were(13.52 mGy-21.86 mGy)and(13.91 mGy-17.92 mGy).In different ages group of pediatric patients,the range of deviation rates of local DRL(LDRLs)value of radiation dose on head of CTDIVOL value to SSDEDW was-8.54%-21.48%.There were strong positive correlations between DW and mAs at 100 and 120 kVp(r=0.96,0.89,P<0.001),respectively.There was stronger consistency between the calculated value by using SSDEDW and actual measurement value by using sAs(ICC=0.98).Conclusion:S

关 键 词：儿童头颅CT 管电流与时间乘积 体型特异性剂量值 诊断参考水平(DRL) 

分 类 号：R816.1[医药卫生—放射医学]