健康体检中肺小结节低剂量CT筛查的辐射剂量优化:迭代重建与自动管电压技术的联合应用  

Optimizing Radiation Dose of Low⁃dose CT Screening for Pulmonary Nodules in Health Examination:Joint Application of Iterative Reconstruction and Automatic Tube Voltage Technology

作　　者：吴桐 麻燕卫 黄晓颖 张海旭 苏泽安 暴云锋[1] WU Tong;MA Yanwei;HUANG Xiaoying;ZHANG Haixu;SU Zean;BAO Yunfeng(Physical Examination Center,Hebei Provincial People’s Hospital,Hebei 050000,China;Department of Medical Imaging,Hebei Provincial People’s Hospital,Hebei 050000,China)

机构地区：[1]河北省人民医院体检中心,河北050000 [2]河北省人民医院医学影像科,河北050000

出　　处：《影像科学与光化学》2025年第2期121-127,共7页Imaging Science and Photochemistry

基　　金：2023年政府资助临床医学优秀人才培养项目(2F2023181)。

摘　　要：目的:评估在健康体检中对肺小结节进行低剂量CT筛查时,不同迭代等级的ADMIRE技术结合自动管电压技术优化辐射剂量的可行性。方法:回顾性分析2024年5月至9月期间116名胸部CT受检者的健康检查数据。将受检者分为常规剂量组和低剂量组,后者进一步根据ADMIRE迭代等级分为两个亚组,ADMIRE 3级设为低剂量A组,ADMIRE 5级设为低剂量B组。比较各组间的辐射剂量指标,包括容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP)和有效剂量(ED),以及图像质量指标,包括噪声(SD)和信噪比(SNR)。同时由高、低年资诊断医师判断图像质量。结果:与常规剂量组相比,低剂量组的CTDIvol、DLP和ED显著降低。在低剂量亚组中,低剂量B组显示出更低的图像噪声,但图像处理过于平滑,略有失真。低剂量A组4分图像占比更高,医师认可度更高。所有组在结节检出方面的诊断准确性一致。结论:结合自动管电压技术和ADMIRE技术,特别是3级迭代,可以在不牺牲诊断准确性的情况下提高图像质量并降低辐射剂量,这为健康体检中的CT扫描提供了一种有前景的方法。Objective:To assess the feasibility of using different iteration levels of ADMIRE technology combined with automatic tube voltage technology for optimizing radiation dose in low⁃dose CT screening for pulmonary nodules during health check⁃ups.Methods:We retrospectively analyzed the health examination data of 116 chest CT examinees from May to September 2024.The examinees were divided into a routine dose group and a low⁃dose group,with the latter further divided into two subgroups according to ADMIRE iteration grade,ADMIRE3 was set as low dose group A and ADMIRE5 was set as low⁃dose group B.The radiation dose indexes,including volume CT dose index(CTDIvol),dose length product(DLP)and effective dose(ED),and image quality indexes,including noise(SD)and signal⁃to⁃noise ratio(SNR),were compared among the groups.At the same time,the image quality was judged by senior and junior doctors.Results:The low⁃dose group demonstrated significantly lower CTDIvol,DLP,and ED compared to the routine dose group.Among the low⁃dose subgroups,low dose group B showed lower image noise but higher smoothness and slight distortion.The proportion of 4⁃point images in low⁃dose group A was higher,and the recognition of doctors was higher.Diagnostic accuracy for nodule detection was consistent across all groups.Conclusion:The integration of automatic tube voltage technology with ADMIRE,particularly at the third iteration,can enhance image quality at lower radiation doses without compromising diagnostic accuracy,making this combinationa promising approach for CT scans in health check⁃up.

关 键 词：健康体检 胸部CT 肺小结节 迭代重建 辐射剂量 

分 类 号：R814.3[医药卫生—影像医学与核医学]