MDCT低剂量扫描诊断消化道出血最优扫描参数的实验研究
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摘要
目的比较不同管电压、管电流及扫描层厚对MDCT诊断消化道出血的图像质量的影响,以期在保证图像质量的基础上获得最优扫描方案,为MDCT双低技术应用于消化道出血的诊断提供研究基础。方法搜集30例于笔者医院行MDCT常规增强检查、手术证实的消化道出血的患者,测量其出血点CT值,计算平均值212.13±64.54HU。以此平均值为参考值配比碘溶液:6.4mgI/ml,120kV对应CT值:214.73±1.63HU。对消化道出血模型行MDCT扫描。常规组:120kV、300mAs、扫描层厚0.9mm;实验组:(A组:100kV、400mAs;B组:80kV、400mAs),扫描层厚1.0、1.5、2.0、2.5、3.0mm。对比剂浓度6.4mgI/ml。由两位放射医师采用双盲法读片,比较常规组与实验各组CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、有效剂量(ED)、图像噪声、计算信噪比,并记录MDCT对模型模拟出血的检出情况,测量出血点CT值。结果常规组DLP、ED与实验各组比较,差异有统计学意义(P<0.05);实验A组1.0、1.5、2.0、2.5mm图像噪声与常规组比较,差异无统计学意义(P>0.05);实验A组1.5、2.0mm图像信噪比与常规组比较,差异无统计学意义(P>0.05);实验A组1.0、1.5、2.0、2.5、3.0mm图像质量主观评分与常规组比较,差异无统计学意义(P>0.05);实验A组1.0、1.5、2.0mm对模型出血的检出率与常规组比较,差异无统计学意义(P>0.05)。结论 MDCT低剂量扫描诊断消化道活动性出血可行,最优扫描参数为100kV、400mAs、1.5mm,其中扫描层厚2.0mm为最厚临界扫描层厚。
Objective To compare the effect of different tube voltage, tube current and scanning layer thickness on the image quality of MDCT to diagnose gastrointestinal bleeding, so as to obtain the optimal scanning scheme on the basis of ensuring image quality.For application of MDCT double low technique in the diagnosis of gastrointestinal bleeding provides research foundation.Methods A total of 30 patients with gastrointestinal hemorrhage confirmed by MDCT routine enhancement examination and surgery were collected to measure the CT value of the bleeding point, average 212.13±64.54 HU. The mean value was the reference value of iodine solution: 6.4 mgI/ml.120 kV corresponds to CT value:214.73±1.63 HU.Different dose CT enhancement scanned for animal models. Conventional group: 120 kV, 300 mAs, scanning layer thickness 0.9 mm; Experimental group:(group A: 100 kV, 400 mAs; Group B: 80 kV, 400 mAs), scanning layer thickness 1.0, 1.5, 2.0, 2.5, 3 mm. The contrast agent concentration was 6.4 mgI/ml, and the injection rate was 0.5 ml/min. The two radiologists used double blind reading tablets, comparing to conventional group and experimental group volume CT dose index(CTDIvol), product of dose length(DLP), effective dose(ED), image noise, SNR calculation, and records the MDCT bleeding detection, the model measurement bleeder CT value. Results There was statistically significant difference between the conventional group DLP, ED and experiment group(P<0.05).For 1.0,1.5,2.0,2.5 mm image noise in the experimental group A, there was no statistically significant difference compared with the conventional dose group(P>0.05). For 1.5,2 mm reconstruction image SNR in experimental group A, there was no statistically significant difference compared with normal group(P>0.05). For 1.0,1.5,2.0,2.5,3 mm reconstructed image quality subjective score in the experimental group A, there was no statistically significant difference compared with normal group(P>0.05). For 1.0 mm, 1.5 mm, 2.0 mm on the model of bleeding detection rate in the experimental group A, there was no statistically significant difference compared with normal group(P>0.05). Conclusion The optimal scanning parameters of MDCT were 100 kV, 400 mAs and 1.5 mm. The thickness of the scanning layer was 2.0 mm thick.
Objective To compare the effect of different tube voltage, tube current and scanning layer thickness on the image quality of MDCT to diagnose gastrointestinal bleeding, so as to obtain the optimal scanning scheme on the basis of ensuring image quality.For application of MDCT double low technique in the diagnosis of gastrointestinal bleeding provides research foundation.Methods A total of 30 patients with gastrointestinal hemorrhage confirmed by MDCT routine enhancement examination and surgery were collected to measure the CT value of the bleeding point, average 212.13±64.54 HU. The mean value was the reference value of iodine solution: 6.4 mgI/ml.120 kV corresponds to CT value:214.73±1.63 HU.Different dose CT enhancement scanned for animal models. Conventional group: 120 kV, 300 mAs, scanning layer thickness 0.9 mm; Experimental group:(group A: 100 kV, 400 mAs; Group B: 80 kV, 400 mAs), scanning layer thickness 1.0, 1.5, 2.0, 2.5, 3 mm. The contrast agent concentration was 6.4 mgI/ml, and the injection rate was 0.5 ml/min. The two radiologists used double blind reading tablets, comparing to conventional group and experimental group volume CT dose index(CTDIvol), product of dose length(DLP), effective dose(ED), image noise, SNR calculation, and records the MDCT bleeding detection, the model measurement bleeder CT value. Results There was statistically significant difference between the conventional group DLP, ED and experiment group(P<0.05).For 1.0,1.5,2.0,2.5 mm image noise in the experimental group A, there was no statistically significant difference compared with the conventional dose group(P>0.05). For 1.5,2 mm reconstruction image SNR in experimental group A, there was no statistically significant difference compared with normal group(P>0.05). For 1.0,1.5,2.0,2.5,3 mm reconstructed image quality subjective score in the experimental group A, there was no statistically significant difference compared with normal group(P>0.05). For 1.0 mm, 1.5 mm, 2.0 mm on the model of bleeding detection rate in the experimental group A, there was no statistically significant difference compared with normal group(P>0.05). Conclusion The optimal scanning parameters of MDCT were 100 kV, 400 mAs and 1.5 mm. The thickness of the scanning layer was 2.0 mm thick.
引文
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8 陈至操.CT小肠成像与胶囊内镜对小肠疾病诊断的对比研究[D].广州:南方医科大学,2015
9 Sun H,Xue HD,Wang YH,et al.Dual-source dual-energy computed tomography angiography for active gastrointestinal bleeding:a preliminary studt[J].Clin Radiol,2013,68(2):139-147
10 Jost G,Lengsfeld P,Lenhard DC,et al.Viscosity of iodinated contrast agents during renal excretion[J].Eur J Radiol,2011,80(2):373-377
11 Mettler FA,Bhargavan M,Faulkner K,et al.Radiologic and nuclear medicine studies in the United States and wordwide:frequenct,radiation dose,and comparison with other radiation sources—1950-2007[J].Radiology,2009,253(2):520-531
12 耿丽莉,李海波.低管电压联合低剂量、低流速对比剂扫描方法在256层CT冠状动脉成像中的应用[J].中国临床研究,2016,29(2):217-220
13 赵勇,李品江.CT噪声和伪影对成像质量的影响及控制[J].中华放射学杂志,1997,31(1):56-58
14 胡永胜.CT扫描层厚改变对图像质量的影响及控制[J].中华放射学杂志,1998,32(4):279-280
15 沈小健,龚建平,李平,等.多层螺旋CT扫描层厚、重建间隔和多平面重建图像质量相关性的实验研究[J].实用放射学杂志,2007,23(7):971-975
16 李丽超,宫凤玲,周立娟,等.输尿管结石CT低剂量扫描中迭代算法最优iDose等级及重建层厚的探讨[J].山东医药,2016,56(11):88-90
17 Golshahi J,Nasri H,Gharipour M.Contrast-induced nephropathy:a literature review[J].Nephropathology,2014,3(2):51-56
2 张桂丽,石磊,王翔宇.MSCT对下消化道出血诊断价值的研究进展[J].中国老年保健医学,2014,12(2):67-68
3 Brenner DJ,Hall EJ.Computed tomography-an increasing source of radiation exposure[J].N Engl J Med,2007,357(22):77-84
4 王忠敏,傅维安,陆志俊,等.CT引导下经皮射频消融治疗肾上腺转移性肿瘤的初步疗效[J].介入放射学杂志,2009,18(5):340-343
5 Jaeckle T,Stuber G,Hoffmann MH,et al.Acute gastrointestinal bleeding:value of MDCT[J].Abdom Imaging,2008,33(3):285-293
6 Chang KJ,Caovan DB,Grand DJ,et al.Reducing radiation dose at CT colonography;decreasing tube voltage to 100 kVp[J].Radiology,2013,266(3):791-800
7 叶文宏,张龚威,汪苍,等.64排螺旋CT扫描及其重建技术在儿童上消化道出血中的诊断价值[J].现代消化及介入诊疗,2016,21(3):484-486
8 陈至操.CT小肠成像与胶囊内镜对小肠疾病诊断的对比研究[D].广州:南方医科大学,2015
9 Sun H,Xue HD,Wang YH,et al.Dual-source dual-energy computed tomography angiography for active gastrointestinal bleeding:a preliminary studt[J].Clin Radiol,2013,68(2):139-147
10 Jost G,Lengsfeld P,Lenhard DC,et al.Viscosity of iodinated contrast agents during renal excretion[J].Eur J Radiol,2011,80(2):373-377
11 Mettler FA,Bhargavan M,Faulkner K,et al.Radiologic and nuclear medicine studies in the United States and wordwide:frequenct,radiation dose,and comparison with other radiation sources—1950-2007[J].Radiology,2009,253(2):520-531
12 耿丽莉,李海波.低管电压联合低剂量、低流速对比剂扫描方法在256层CT冠状动脉成像中的应用[J].中国临床研究,2016,29(2):217-220
13 赵勇,李品江.CT噪声和伪影对成像质量的影响及控制[J].中华放射学杂志,1997,31(1):56-58
14 胡永胜.CT扫描层厚改变对图像质量的影响及控制[J].中华放射学杂志,1998,32(4):279-280
15 沈小健,龚建平,李平,等.多层螺旋CT扫描层厚、重建间隔和多平面重建图像质量相关性的实验研究[J].实用放射学杂志,2007,23(7):971-975
16 李丽超,宫凤玲,周立娟,等.输尿管结石CT低剂量扫描中迭代算法最优iDose等级及重建层厚的探讨[J].山东医药,2016,56(11):88-90
17 Golshahi J,Nasri H,Gharipour M.Contrast-induced nephropathy:a literature review[J].Nephropathology,2014,3(2):51-56