基于自动管电流调制技术不同定位像组合方式在头颈部CT血管成像检查中辐射剂量和图像质量的应用研究  

Study on radiation dose and image quality in CTA examination of head and neck based on different positioning image combinations of ATCM technology

作　　者：袁超 何朝梁 杨洁 李艳[1] 但虹甫 冯浩[1] 仲建全[1] Yuan Chao;He Chaoliang;Yanng Jie;Li Yan;Dan Hongfu;Feng Hao;Zhong Jianquan(Department of Radiology,Zigong First People′s Hospital,Sichuan 643000,China)

机构地区：[1]四川省自贡市第一人民医院放射科,643000

出　　处：《实用医学影像杂志》2025年第2期138-143,共6页Journal of Practical Medical Imaging

摘　　要：目的探讨自动管电流调制技术(ATCM)用于头颈部CT血管造影(CTA)联合扫描时,不同定位像扫描顺序以及扫描范围方式对辐射剂量和图像质量的影响。方法根据定位像扫描顺序及扫描范围分为4组(A组:头颈部侧位像+头颈部正位像,B组:头颈部正位像+头颈部侧位像,C组:头部侧位像+颈部正位像,D组:颈部正位像+头部侧位像),在自动管电流技术下,采用临床头颈部CTA联合参数对仿真模体及头颈部血管病变患者均行GE 256排Revolution CT扫描。记录容积CT剂量指数(CTDIvol)和剂量长度乘积(DLP),并测量图像CT均值(AV)、标准差(SD),计算有效辐射剂量(ED)、信噪比均值(SNRav)、对比度噪声比均值(CNRav)和品质因子(FOM)。辐射剂量与图像客观评价采用单因素方差分析;图像主观评价由2名高年资医师采用双盲法进行评价,评价一致性采用Kappa检验。结果体模研究中,采用C组定位像行头颈部CTA扫描的辐射剂量最低,差异有统计学意义(P<0.01),FOM差异有统计学意义(P<0.05)SNRav、CNRav差异无统计学意义(P>0.05)。临床研究中,D组扫描辐射剂量最低,差异具有统计学意义(P<0.05)。4组CTDIvol、DLP、ED差异有统计学意义(P<0.01)。4组图像SNRav、CNRav、FOM差异无统计学意义(P>0.05);图像主观评价一致性较好(Kappa=0.708)。结论基于ATCM技术下,头颈部CTA扫描推荐采用颈部正位+头部侧位定位像,能保证图像质量前提下进一步优化辐射剂量。Objective To investigate the effects of different positioning image scanning sequences and scanning ranges on radiation dose and image quality when automatic tube current modulation(ATCM)is used for combined head and neck CT vascular(CTA)scanning.Methods Four groups were divided according to the scanning sequence and range of localization images(group A:head and neck lateral image combimed with head and neck anteroposterior image,group B:head and neck anteroposterior image combimed with head and neck lateral image,group C:head lateral image combimed with neck anteroposterior image,and group D:neck anteroposterior imagecombimed with head lateral image),with the automatic tube current technology,GE 256-row Revolution CT scan was performed on both the simulated model and the patients with head and neck vascular diseases using clinical head and neck CTA combined parameters.The volume CT dose index(CTDIvol)and dose-length product(DLP)were recorded,the image CT mean(AV)and standard deviation(SD)were measured,and the effective radiation dose(ED),mean signal-to-noise ratio(SNRav),mean contrast to noise ratio(CNRav)and quality factor(FOM)were calculated.Single-factor analysis of variance was used to evaluate radiation dose and image objectively.The image subjective evaluation was performed by two senior physicians using the double-blind method,and the Kappa test was used for evaluation consistency.Results In the body model study,the radiation dose of CTA scanning of the head and neck using the positioning image in group C was the lowest,with a statistical difference(P<0.01),There was statistical significance in FOM(P<0.05),but no statistical significance in SNRav,and CNRAV(P>0.05).In the clinical study,the scanning radiation dose of group D was the lowest,with a statistical difference(P<0.05).There were significant differences in CTDIvol,DLP,and ED among the 4 groups(P<0.01).There was no significant difference in SNRav,CNRav,and FOM among the 4 groups(P>0.05).The consistency of image subjective evaluation was good(Kappa=0

关 键 词：调制解调器 定位标记 头颈部肿瘤 辐射剂量 图像质量 

分 类 号：R814.2[医药卫生—影像医学与核医学]