低剂量管电流联合SAFIRE技术在胸部CT体检中的应用
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摘要
目的:探讨不同管电流扫描下胸部CT的图像质量以及管电流20mAs联合SAFIRE迭代重建技术在胸部CT体检人群中的应用价值。方法:收集胸部CT扫描下的体检人员120例,根据不同管电流胸部CT扫描分为20mAs组、30mAs组、60mAs组及100mAs组,每组30例,以主观及客观方法(信噪比)分别评价肺窗及纵膈窗的图像质量,其中20mAs组肺窗图像采用SAFIRE迭代重建技术。由两名高年资放射科医师分别在纵膈窗及肺窗对图像质量进行双盲法评分,并测量和比较各组的有效辐射剂量、信噪比。结果:主观评价,各组肺窗图像质量评分比较,差异无统计学意义(P>0.05);纵膈窗图像质量60mAs组与100mAs组评分高于20mAs组与30mAs组,30mAs组评分高于20mAs组(均P<0.05)。客观评价,各组纵膈窗降主动脉、右侧竖脊肌及背部皮下脂肪的信噪比比较,差异均有统计学意义(均P<0.01),即随着管电流的降低,图像的信噪比随之降低(P<0.01)。各组肺窗下左、右肺信噪比比较,差异均有统计学意义(均P<0.05),其中管电流20mAs组联合SAFIRE技术肺窗图像质量最高,100mAs、60mAs、30mAs组肺窗图像质量(信噪比)随着管电流减低依次降低。结论:管电流20mAs联合SAFIRE技术能满足体检人群诊断的图像质量标准,同时降低有效辐射剂量。
Objective:To investigate the image quality of chest CT under different tube current scanning and the application value of 20 mAs combined with SAFIRE technique in physical examination.Methods:A total of 120 subjects who underwent chest CT examination in our hospital were enrolled.The image quality of lung window and mediastinal window in different tube currents(20 mAs,30 mAs,60 mAs,100 mAs)was evaluated.The lung window images form the subjects of 20 mAs group were reconstructed using sinogram affirmed iterative reconstruction(SAFIRE)technique.Effective radiation dose and signal-to-noise ratio(SNR)were measured by two senior radiologists with double blind method.Results:By subjective evaluation,there was no significant difference in lung window image quality(P>0.05).The subjective evaluation of mediastinal window image quality was statistically significant between any two groups(P<0.05)except for 60 mAs group and 100 mAs group,and the image quality score decreased when tube current decreased.In the objective evaluation,there was significant difference in lung window and mediastinal window image quality between any two groups(P<0.05).On the mediastinal window,the SNR of descending aorta,right erector spinae and subcutaneous decreased when tube current decreased.On the lung window,the image quality of 20 mAs group combined with SAFIRE technology was the best in lung window,in the other groups,the SNR decreased when tube current decreased.Conclusion:Tube current 20 mAs combined with SAFIRE technique can meet the image quality standard of clinical diagnosis for physical examination and reduce the effective radiation dose.
Objective:To investigate the image quality of chest CT under different tube current scanning and the application value of 20 mAs combined with SAFIRE technique in physical examination.Methods:A total of 120 subjects who underwent chest CT examination in our hospital were enrolled.The image quality of lung window and mediastinal window in different tube currents(20 mAs,30 mAs,60 mAs,100 mAs)was evaluated.The lung window images form the subjects of 20 mAs group were reconstructed using sinogram affirmed iterative reconstruction(SAFIRE)technique.Effective radiation dose and signal-to-noise ratio(SNR)were measured by two senior radiologists with double blind method.Results:By subjective evaluation,there was no significant difference in lung window image quality(P>0.05).The subjective evaluation of mediastinal window image quality was statistically significant between any two groups(P<0.05)except for 60 mAs group and 100 mAs group,and the image quality score decreased when tube current decreased.In the objective evaluation,there was significant difference in lung window and mediastinal window image quality between any two groups(P<0.05).On the mediastinal window,the SNR of descending aorta,right erector spinae and subcutaneous decreased when tube current decreased.On the lung window,the image quality of 20 mAs group combined with SAFIRE technology was the best in lung window,in the other groups,the SNR decreased when tube current decreased.Conclusion:Tube current 20 mAs combined with SAFIRE technique can meet the image quality standard of clinical diagnosis for physical examination and reduce the effective radiation dose.
引文
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[11]王杰,曾勇明,彭刚,等.SAFIRE重建算法对胸部CT图像质量和辐射剂量的影响[J].中国医学影像技术,2013,29(11):1896-1900.
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[13]DIEDERICH S,LENZEN H,WINDMANN R,et al.Pulmonary nodules:experimental and clinical studies at low-dose CT[J].Radiology,1999,213(1):289-298.
[14]赵海波,龙腾河,罗焕江.螺旋CT实时剂量调节预设值mAs与辐射剂量、图像质量相关性研究[J].实用放射学杂志,2013,29(7):1169-1172.
[15]李莹,吕培杰,郭英,等.优化前后置全模型迭代重建技术低剂量腹部CT扫描[J].中国医学影像技术,2018,34(4):605-609.
[2]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.
[3]中华医学会放射学分会心胸学组.低剂量螺旋CT肺癌筛查专家共识[J].中华放射学杂志,2015,49(5):328-335.
[4]冉姗姗,綦维维,张淼,等.多参数设置对低剂量胸部CT扫描图像质量及辐射剂量的影响[J].中国医学影像技术,2018,34(1):113-117.
[5]PICOZZI G,PACI E,PEGNA A L,et al.Screening of lung cancer with low dose spiral CT:results of a three year pilot study and design of the randomised controlled trial“Italung-CT”[J].La Radiologia Medica,2005,109(1-2):17-26.
[6]张丽,于红,刘士远,等.迭代重建技术对低剂量肺部平扫CT图像质量的影响[J].中华放射学杂志,2013,47(4):316-320.
[7]黄福灵,赵欣.迭代算法在小儿胸部低剂量扫描中的应用[J].哈尔滨医药,2015,35(S1):86-87.
[8]EINSTEIN A J,MOSER K W,THOMPSON R C,et al.Radiation dose to patients from cardiac diagnostic imaging[J].Circulation,2007,116(11):1290-1305.
[9]黄洁惠,宋歌,石磊.低剂量螺旋CT的原理及临床应用[J].肿瘤学杂志,2016,22(4):316-321.
[10]左秀娟,贺太平,张开元,等.新一代基于模型的迭代算法在胸部低剂量CT筛查中的应用[J].放射学实践,2018,33(10):100-104.
[11]王杰,曾勇明,彭刚,等.SAFIRE重建算法对胸部CT图像质量和辐射剂量的影响[J].中国医学影像技术,2013,29(11):1896-1900.
[12]BRADY S L,MOORE B M,YEE B S,et al.Pediatric CT:implementation of ASIR for substantial radiation dose reduction while maintaining pre-ASIR image noise[J].Radiology,2014(270):223-231.
[13]DIEDERICH S,LENZEN H,WINDMANN R,et al.Pulmonary nodules:experimental and clinical studies at low-dose CT[J].Radiology,1999,213(1):289-298.
[14]赵海波,龙腾河,罗焕江.螺旋CT实时剂量调节预设值mAs与辐射剂量、图像质量相关性研究[J].实用放射学杂志,2013,29(7):1169-1172.
[15]李莹,吕培杰,郭英,等.优化前后置全模型迭代重建技术低剂量腹部CT扫描[J].中国医学影像技术,2018,34(4):605-609.