儿童胸部数字化X线摄影参数优化与成像质量探讨
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摘要
目的探讨通过优化小儿胸部数字化X线摄影的曝光参数,提高小儿摄影成像质量,减少小儿辐射剂量和重复摄影率。方法利用动物肺脏与X线衰减模体的不同厚度组合来模拟不同体厚的小儿,通过对模体、分辨率线队卡进行一系列曝光,kV值选择范围45～100 kV,采用自动曝光AEC、中野电离室曝光,记录各项参数。通过对曝光时间、曝光指数、辐射剂量以及图像分辨率制定出符合诊断要求的kV和mAs值。对来我院就诊的240名患儿分为2组,对照组采用设备厂家提供的曝光参数,观察组采用优化的曝光参数,比较图像质量和辐射剂量。结果不同厚度PMMA模体与动物肺脏组合后,分别与0～0.5、0.6～2、3～5、6～8岁儿童曝光参数接近。通过模体制定出符合不同年龄段曝光参数kV和mAs值。与对照组患儿相比,观察组患儿DR图像质量的评分及甲级片率均较高,其重复摄影率较低,辐射剂量值明显降低,其差异均具有统计学意义(P<0.05)。结论根据小儿年龄和体重的不同,制定不同的曝光参数是可行的,不但可以提高检查质量,而且可以有效降低小儿辐射剂量。
Objective To explore the exposure parameters of digital X-ray radiography(DR) by optimizing pediatric chest, improve the quality of pediatric photographic imaging, reduce radiation dose and repetition rate in children. Methods Different thickness combinations of lung and X-ray attenuation modes were used to simulate children with different body thickness. Through a series of exposure on the model body and resolution line card, the kV range was 45～100 kV, automatic exposure AEC and infield ionization chamber were adopted, and various parameters were recorded. Then the kV and mAs values that met the diagnostic requirements were determined by the exposure time, exposure index, radiation dose and image resolution. The 240 children who came to our hospital were divided into two groups. The exposure parameters provided by the equipment manufacturer were used in the control group, and the optimized exposure parameters were used in the observation group to compare the image quality and radiation dose. Results The exposure parameters of PMMA modules with different thickness were close to 0～0.5, 0.6～2, 3～5, 6～8 years old children. Then the kV and mAs values of exposure parameters were determined by the mode system. Compared with children in the control group, the quality of DR images in the observation group was higher than that of the first grade, the repeated photographic rate was lower, and the radiation dose(DAP) was significantly reduced. The difference was statistically significant(P<0.05). Conclusion It is feasible to establish different exposure parameters according to children's age and weight, which can not only improve the quality of inspection, but also reduce the radiation dose of children.
Objective To explore the exposure parameters of digital X-ray radiography(DR) by optimizing pediatric chest, improve the quality of pediatric photographic imaging, reduce radiation dose and repetition rate in children. Methods Different thickness combinations of lung and X-ray attenuation modes were used to simulate children with different body thickness. Through a series of exposure on the model body and resolution line card, the kV range was 45～100 kV, automatic exposure AEC and infield ionization chamber were adopted, and various parameters were recorded. Then the kV and mAs values that met the diagnostic requirements were determined by the exposure time, exposure index, radiation dose and image resolution. The 240 children who came to our hospital were divided into two groups. The exposure parameters provided by the equipment manufacturer were used in the control group, and the optimized exposure parameters were used in the observation group to compare the image quality and radiation dose. Results The exposure parameters of PMMA modules with different thickness were close to 0～0.5, 0.6～2, 3～5, 6～8 years old children. Then the kV and mAs values of exposure parameters were determined by the mode system. Compared with children in the control group, the quality of DR images in the observation group was higher than that of the first grade, the repeated photographic rate was lower, and the radiation dose(DAP) was significantly reduced. The difference was statistically significant(P<0.05). Conclusion It is feasible to establish different exposure parameters according to children's age and weight, which can not only improve the quality of inspection, but also reduce the radiation dose of children.
引文
[1]GB 16348-2010,医用X射线诊断受检者放射卫生防护标准[S].北京:中国标准出版社,2010.
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[3]刘晓晗,王子军.数字减影血管造影低剂量技术在儿童介入诊疗中的应用[J].中国医学装备,2015,12(4):71-73.
[4]张效平,贺松,吴伟.降低小儿胸部DR摄影辐射剂量的研究[J].中国医学装备,2013,10(7):34-36.
[5]Uffmann M,Neitzel U,Prokop M,et al.Falt-panel-detector chest radiography:effect of tube voltage on image quality[J].Radiation,2005,235:642-650.
[6]李竹强.小儿胸部滤线器摄影[J].实用放射学杂志,2005,21(11):1127.
[7]王平,刘景鑫,吕岩.CR图像空间分辨率实验分析[J].吉林医学,2008,29(15):1305-1306.
[8]Kirpalani H,Nahmias C.Radiation risk to children from computed tomography[J].Pediatrics,2008,121(2):449-450.
[9]马国林,王武,张彦彩.儿童螺旋CT低剂量扫描的临床应用[J].中华放射医学与防护杂志,2011,31(1):111-114.
[10]赵红兰,平杰,吴笑松,等.婴幼儿胸部DR摄影千伏对辐射效能和图像质量的影响[J].实用放射学杂志,2012,28(8):1270-1273.
[11]臧桂霞,闫淯淳,许书聪,等.婴幼儿胸部数字化X射线摄影曝光参数的优化[J].中华放射医学与防护杂志,2017,37(6):476-480.
[12]刘建清.直接数字化X线摄影(DR)在小儿胸片中的应用优势[J].吉林医学,2012,33(14):3006-3007.
[13]Strotzer M,V?lk M,Fründ R,et a1.Routinechest radiography using a fiat-panel detector.image quality at standard detector dose and 33%dose reduction[J].AJR Am J Roentgenol,2002,17(1):169-171.
[14]袁聿德.医学影像检查技术[M].北京:人民卫生出版社,2002.
[15]张效平,贺松.附加滤过在婴幼儿胸部DR摄影中降低辐射剂量的价值[J].中国医疗设备,2013,28(5):114-115.
[16]李金霞,杨旭,赵宏波.DR不同类型平板探测器性能的比较研究[J].中国医学装备,2011,8(8):25-27.
[2]Dougeni ED,Delis HB,Karatza AA,et al.Dose and image quality optimization in neonatal radiography[J].Brit JRadiol,2007,80(958):512-515.
[3]刘晓晗,王子军.数字减影血管造影低剂量技术在儿童介入诊疗中的应用[J].中国医学装备,2015,12(4):71-73.
[4]张效平,贺松,吴伟.降低小儿胸部DR摄影辐射剂量的研究[J].中国医学装备,2013,10(7):34-36.
[5]Uffmann M,Neitzel U,Prokop M,et al.Falt-panel-detector chest radiography:effect of tube voltage on image quality[J].Radiation,2005,235:642-650.
[6]李竹强.小儿胸部滤线器摄影[J].实用放射学杂志,2005,21(11):1127.
[7]王平,刘景鑫,吕岩.CR图像空间分辨率实验分析[J].吉林医学,2008,29(15):1305-1306.
[8]Kirpalani H,Nahmias C.Radiation risk to children from computed tomography[J].Pediatrics,2008,121(2):449-450.
[9]马国林,王武,张彦彩.儿童螺旋CT低剂量扫描的临床应用[J].中华放射医学与防护杂志,2011,31(1):111-114.
[10]赵红兰,平杰,吴笑松,等.婴幼儿胸部DR摄影千伏对辐射效能和图像质量的影响[J].实用放射学杂志,2012,28(8):1270-1273.
[11]臧桂霞,闫淯淳,许书聪,等.婴幼儿胸部数字化X射线摄影曝光参数的优化[J].中华放射医学与防护杂志,2017,37(6):476-480.
[12]刘建清.直接数字化X线摄影(DR)在小儿胸片中的应用优势[J].吉林医学,2012,33(14):3006-3007.
[13]Strotzer M,V?lk M,Fründ R,et a1.Routinechest radiography using a fiat-panel detector.image quality at standard detector dose and 33%dose reduction[J].AJR Am J Roentgenol,2002,17(1):169-171.
[14]袁聿德.医学影像检查技术[M].北京:人民卫生出版社,2002.
[15]张效平,贺松.附加滤过在婴幼儿胸部DR摄影中降低辐射剂量的价值[J].中国医疗设备,2013,28(5):114-115.
[16]李金霞,杨旭,赵宏波.DR不同类型平板探测器性能的比较研究[J].中国医学装备,2011,8(8):25-27.