目的 探讨自动管电流调制技术(automatic tube current modulation, ATCM)对腹部CT图像质量及辐射剂量的影响。方法 随机抽取2018-09至2019-09部队查体时180名官兵,分成对照组40名,采用固定管电流400 mA进行CT扫描;实验组140名,采用ATCM进行CT扫描。分别记录两组扫描方案的辐射剂量指标:容积CT剂量指数(volumetric CT dose index, CTDIvol)、剂量长度积(dose length product, DLP)、个体化剂量估计值(size specific dose estimates, SSDE)、有效剂量(effective dose, ED)。此外,测量各组图像中阑尾、腰大肌及皮下脂肪CT值,计算得到图像质量客观评价指标:同层皮下脂肪CT值标准差(standard deviation, SD)、阑尾和腰大肌信噪比(signal to noise ratio, SNR)。由两名从事影像诊断工作15年以上医师对两组图像资料进行主观评价并记录评分。对两组辐射剂量、图像质量的比较使用单因素方差分析;对NI值与CTDIvol、DLP的相关性采用Pearson相关分析。2位影像科医师对各组CT图像质量评分的一致性分析使用Kappa检验。结果 两组CTDIvolm、DLPm、SSDEm、EDm的检验值F分别为3.14、8.75、1.82、7.34,差异有统计学意义(P<0.05),实验组较对照组有明显辐射剂量下降;图像质量有一定程度的下降,两组SD、SNRA、SNRPM的统计学检验值F分别为1.22、2.93、5.38,差异有统计学意义(P<0.05)。两组图像评分对比检验值F=1.34,P=0.176,差异无统计学意义;NI值与CTDIvol、DLP成呈显著性负相关(r=-0.919,P<0.05);2名影像科医师对CT图像评分具有较强的一致性(Kappa=0.675)。结论 ATCM扫描对腹部CT检查诊断效果可靠,且可大幅度降低辐射剂量,建议推广。
Abstract
Objective To investigate the effect of automatic tube current modulation (ATCM) on abdominal CT image quality and radiation dose.Methods One hundred and eighty servicemen were randomly selected and divided into two groups for abdominal CT scan. The 40 people in the control group were scanned with the fixed tube current of 400mA while the 140 subjects in the experimental group were scanned by ATCM. The radiation dose indexes of each scanning scheme were recorded respectively, including the volumetric CT dose index (CTDIvol), dose length product (DLP), size-specific dose estimates (SSDE), and effective dose (ED). In addition, the CT values of the appendix, psoas major and subcutaneous fat in the images of each group were measured, and the Objective evaluation index of image quality was calculated. At the same time, two physicians who had been engaged in imaging diagnosis for more than 15 years made subjective evaluation of the two groups of images and recorded their scores. Univariate analysis of variance was used to compare the radiation doses and image quality between the two groups. The correlation between NI values and CTDIvol,DLP was analyzed via Pearson correlation analysis. Kappa test was used to analyze the consistency of CT image quality scores of the two imaging physicians in each group.Results The test values F of CTDIvolm, DLPm, SSDEm and EDm in the two groups were 3.14, 8.75, 1.82, 7.34, respectively (P<0.05), showing statistically significant difference. Compared with the control group, the experimental group had a significant reduction in the radiation dose. The image quality decreased to some extent. The statistical test values F of SD, SNRA and SNRPM in the two groups were 1.22, 2.93 and 5.38, respectively (P<0.05). The data difference between the two groups was statistically significant. The comparison test value of image scores between the two groups was F=1.34, P=0.176, with no statistically significant difference. There was a significant negative correlation between NI and CTDIvol DLP (r=-0.919,P<0.05). The consistency analysis of CT image scores by the two imaging physicians showed a strong consistency (Kappa=0.675).Conclusions ATCM used for abdominal CT examination can greatly reduce the radiation dose while ensuring the accuracy of diagnosis. It is highly applicable.
关键词
体层射影术 /
X线计算机 /
辐射剂量 /
腹部
Key words
tomography /
X-ray computed /
radiation dose /
abdomen
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参考文献
[1] 王俊琴,刘太峰,张海燕.智能最佳管电压联合自动管电流在降低胸部CT扫描剂量中的应用[J].临床放射学杂志,2019,38(5):931-935.
[2] 杜恒鑫,侯 阳,王一婧,等.全模型迭代重建技术对低剂量CT冠状动脉支架显示的初步研究[J].中国临床医学影像杂志,2019,30(1):57-60.
[3] 曹治婷,陈 刚,刘铁军,等.双低技术结合iDose43级迭代重建在CT肺动脉成像中的应用[J].实用放射学杂志,2018,34(9):1438-1442.
[4] 唐 慧,贺太平,燕洋洋,等.ASIR算法联合自动管电流技术在胸部低剂量CT扫描中的应用[J].实用放射学杂志,2018,34(1):109-113.
[5] Funama Y,Awai K,Nakayama Y, et al.Radiation dose reduction without degradation of low-contrast detectability at abdominal multisection CT with a low-tube voltage technique: phantom study.[J].Radiology,2005,237(3):905-910.
[6] 朱 正,赵心明,周纯武.宝石能谱单能量成像及自适应统计迭代重建技术在腹部低剂量CT扫描中的可行性研究[J].放射学实践,2017,32(4):418-422.
[7] 胡敏霞,赵心明,宋俊峰, 等.64层螺旋CT腹部扫描参数优化的初步研究[J].中华放射学杂志,2011,45(3):264-269.
[8] Bhargavan M,Mettler F A,Faulkner K.Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources1950-2007.[J].Radiology,2009,253(2):520-531.
[9] Naidich D P, Marshall C H, Gribbin C, et al. Low-dose CT of the lungs:preliminary observations[J].Radiology,1990, 175(3):729-731.
[10] 王 淼,肖志清,王艳强, 等.合理应用X射线检查优化辐射剂量[J].中华放射医学与防护杂志,2019,39(1):1-5.
[11] 刘士远,于 红.积极推进胸部低剂量CT扫描的临床应用[J].中华放射学杂志,2010,44(1):6-7.
[12] 张金英,邢璐,伏平友, 等.CT个体化低剂量扫描在普通人群胸部体检中的应用[J].山东医药,2017,57(17):88-90.
[13] 赵小英,吴兴旺,刘 斌.自动管电流调节下不同管电压及噪声指数行下肢 CTA 的初步研究[J].实用放射学杂志,2015,(9):1531-1534.
[14] 王 倩,赵心明,宋俊峰, 等.自动管电流调制技术对腹部CT图像质量及辐射剂量影响的体模研究[J].中华放射学杂 志,2013,47(7):648-653.
[15] 彭 刚,曾勇明,罗天友, 等.中国人仿真胸部体模检测多层螺旋CT扫描组织器官剂量的研究[J].中华放射学杂志,2011,45(6):584-588.
[16] 石 全.MSCT及MPR后处理技术在诊断阑尾疾病中应用[J].影像研究与医学应用,2019,3(18):25-27.
[17] Jyotindu D, George R A, Ravikumar R.Imaging in acute appendicitis: what, when, and why?[J].Medical Journal Armed Forces India,2017,73(1):74-79.
[18] 陈 欣,杨 柳,段小军.某部特种兵军事训练伤流行病学调查与分析[J].人民军医,2019,62(4):305-306,310.
[19] 严怀宁,叶 荣,王长峰,等.武警某部540名新兵采用核心肌群训练防治慢性下腰痛[J].武警医学,2019,30(2):181-182.
[20] 浦仁旺,刘义军,卢绪论, 等.基于体质量指数的个性化噪声指数设定在腹部CT成像中的应用研究[J].中国临床医学影像杂志,2016,27(7):487-490.
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