64排螺旋CT优化扫描方案在儿童小气道病变的研究及应用价值
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摘要
目的:利用儿童胸部螺旋CT容积数据,比较两种不同重建算法和四种重建层厚显示儿童肺部细小结构的差异,探求显示肺细小结构的最佳方法。同时研究不同辐射剂量下肺内细小结构的显示情况,寻求显示儿童小气道病变的优化扫描方案。
方法:①最佳重建算法与最佳层厚的选择:回顾性分析200例胸部螺旋CT(MSCT)容积数据资料,运用骨算法(VHRCT)和标准算法分别重建0.625 mm、1.25 mm、2.5 mm和5 mm薄层图像,比较两种算法和不同层厚显示左肺上叶尖段小支气管的情况。②扫描剂量的选择:对肺模型行MSCT容积扫描和传统HRCT扫描,在管电压恒定的条件下,分别设置管电流120 mA、100 mA、80 mA、50 mA、20 mA,5组。比较两种不同扫描方法在不同管电流条件下的辐射剂量变化,以及不同辐射剂量下VHRCT图像与HRCT图像客观噪声及显示小气道情况的差异。
结果:①两种重建算法与四种层厚显示肺内细小结构的差异性:相同层厚下,VHRCT图像显示左上肺尖段小支气管较标准重建图像效果好;VHRCT图像的0.625 mm与1.25 mm层厚重建均能清楚显示左上肺尖段小支气管,两组间无显著性差异(P>0.05),0.625 mm评分较1.25 mm高,提示0.625 mm图像显示最佳;2.5 mm与5 mm层厚重建则不能清晰显示。②不同管电流时,0.625 mm的VHRCT图像与HRCT图像质量的差异性:MSCT容积扫描和传统HRCT扫描,管电压不变时,辐射剂量(CTDIw)和剂量长度乘积(DLP)与管电流成正比关系。当管电压为120 kV,管电流为120 mA、100 mA、80 mA、50 mA组VHRCT和HRCT图像均能清楚显示小气道情况,图像噪声值无显著性差异(P>0.05)。管电流为20 mA时,VHRCT和HRCT均不能清楚显示小气道情况。
结论:①VHRCT图像显示肺内细小结构效果比标准重建图像好。②不同层厚的VHRCT图像中,0.625 mm的层厚显示肺内细小结构最好。③在管电流固定的条件下,容积扫描和传统HRCT扫描的辐射剂量与管电流呈正比。④VHRCT与HRCT图像噪声及显示肺内细小结构无明显差别,说明在不增加辐射剂量的前提下,宜选用VHRCT代替HRCT诊断肺小气道病变。⑤在管电压120 kV,管电流≥50 mA层厚为0.625 mm的VHRCT图像可显示儿童肺内细小结构。可将此方案作为显示小气道病变的优化扫描方案。
目的:回顾性分析117例儿童支原体肺炎64排CT胸部低剂量扫描VHRCT影像表现,研究儿童支原体肺炎VHRCT重建图像的小气道病变表现特点。
方法:对117例临床确诊的儿童支原体肺炎患儿行64排螺旋CT胸部低剂量扫描,管电压:120 kV,管电流:50 mA,容积数据行0.625 mm的VHRCT重建。
结果:117例患儿中,男77例,女40例,年龄6月～14岁,平均6.7岁±3.1岁。实变共93例,其中节段性叶实变影76例,伴支气管充气征34例,肺节段性部分性不张18例,小叶性实变17例;肺门或纵隔淋巴结肿大37例,胸腔积液36例;气胸3例;纵隔气肿2例。小气道的改变:树芽征59例,小叶中心结节影54例;磨玻璃影15例,马赛克灌注征11例,细支气管扩张26例。
结论:儿童支原体肺炎的薄层VHRCT重建图像主要表现为肺实变伴少量胸腔积液和淋巴结肿大;部分病人有小气道改变,主要表现为树芽征或小叶中心结节,可与大片实变并存,也可单独出现,其边缘较模糊、密度较低为特征性。薄层VHRCT重建图像对支原体肺炎小气道病变的诊断有重要价值。
Objective: Volume dates of children,s chest CT were used to study the differences of two different reconstruction algorithms and four reconstruction slice thickness in displaying the small airways. Structure of small airways were displayed in different radiation doses. And the optimization program,to display the small airways of lungs,was researched.
Methods:①Optimal thickness and optimal reconstruction algorithm: Volume datas of 200 patients with chest spiral CT (MSCT) were retrospectively analysised.VHRCT and standard algorithms were used to display the small airways in 0.625mm, 1.25mm, 2.5 mm and 5mm, respectively.And image quality of two algorithms and different thickness on the small bronchi of the left lung tip section were compared.②Dose selection: volume and conventional HRCT scan in lung phantom MSCT: tube voltage 120kV, tube current 120mA, 100 mA, 80 mA, 50mA, 20mA,respectively.Dose of two different scanning methods and different tube current and the image quality were compared between HRCT and VHRCT.
Results:①Two reconstruction algorithms and four different thickness were used to observe the small structure of small airway. In the same thickness, VHRCT shows a better image than the standard reconstruction to discover the bronchiole of left apical segment.In VHRCT , both 0.625mm and 1.25mm thickness can show the bronchiole of left apical segment clearly , there was no significant difference (P> 0.05),but the scores of 0.625mm was higher than 1.25mm, suggest that the best image display was 0.625mm.②In different tube currents, difference were studied between VHRCT and HRCT in 0.625mm:In the same tube currents,both MSCT and HRCT scan,there was a positive proportional relationship between CTDIw or DLP and the tube current. 120kV in the tube voltage, 120mA, 100 mA, 80 mA, 50mA in tube current , VHRCT and HRCT images can clearly show the situation of small airway, there was no significant difference (P> 0.05), both VHRCT and HRCT can not clearly display the small airway in 20mA of tube current.
Conclusion:①VHRCT is better than standard reconstruction to discover the small airway of lungs.②0.625mm is the best to discover the bronchiole in different thickness of VHRCT.③In the same tube current, there is a positive proportional relationship between radiation dose and MSCT or HRCT.④There is no significant difference to discover the small structure between VHRCT and HRCT, demostrate that VHRCT can replace HRCT to dignosis the disease of small airway ,without increasing the radiation dose .⑤In VHRCT, 120kV in tube voltage, more than 50mA in tube current and thickness in 0.625mm,small structure of lungs can be showed clearly.This program can be used as optimization strategy to display disease of small airway.
Objective:To explore the thin reconstruction of low-dose 64-slice CT in 117 children with mycoplasma pneumoniae pneumonia,to study small airway feature in the VHRCT of mycoplasma pneumonia.
Methods:117 children with mycoplasma pneumonia underwent low-dose64-slice chest CT scan, tube voltage: 120kV, tube current: 50mA, and volume HRCT reconstruction.
Results:The results of the thin reconstruction of low-dose 64-slice CT in 117 cases were as follows: Consolidation were observed in 93 cases, lobar or segmental consolidation were observed in 76 cases, which with bronchial inflatable sign in 34 cases and with mild volume decrease of the involved lobe in 18 cases; lobular consolidation were observed in 17 cases.
Lymphadenectasis were showed in 37 cases and pleural effusion were seen in 36 cases; pneumothorax and mediastinal emphysema were detected in 3 cases and 2 cases. Small airway changes: tree in bud was observed in 59 cases, centrilobular nodules in 54 cases, ground-glass shadow in 15 cases, mosaic perfusion syndrome in 11 cases and small bronchiectasis in 26 cases.
Conclusion:The main appearances of children with mycoplasma pneumoniae pneumonia are the tree-in-bud pattern or centrilobular nodules,which can appearence with consolidation The tree-in-bud pattern are vague of edges and low density. Thin reconstruction volume HRCT have a novel value in diagnosis of mycoplasma pneumoniae pneumonia in children.
方法:①最佳重建算法与最佳层厚的选择:回顾性分析200例胸部螺旋CT(MSCT)容积数据资料,运用骨算法(VHRCT)和标准算法分别重建0.625 mm、1.25 mm、2.5 mm和5 mm薄层图像,比较两种算法和不同层厚显示左肺上叶尖段小支气管的情况。②扫描剂量的选择:对肺模型行MSCT容积扫描和传统HRCT扫描,在管电压恒定的条件下,分别设置管电流120 mA、100 mA、80 mA、50 mA、20 mA,5组。比较两种不同扫描方法在不同管电流条件下的辐射剂量变化,以及不同辐射剂量下VHRCT图像与HRCT图像客观噪声及显示小气道情况的差异。
结果:①两种重建算法与四种层厚显示肺内细小结构的差异性:相同层厚下,VHRCT图像显示左上肺尖段小支气管较标准重建图像效果好;VHRCT图像的0.625 mm与1.25 mm层厚重建均能清楚显示左上肺尖段小支气管,两组间无显著性差异(P>0.05),0.625 mm评分较1.25 mm高,提示0.625 mm图像显示最佳;2.5 mm与5 mm层厚重建则不能清晰显示。②不同管电流时,0.625 mm的VHRCT图像与HRCT图像质量的差异性:MSCT容积扫描和传统HRCT扫描,管电压不变时,辐射剂量(CTDIw)和剂量长度乘积(DLP)与管电流成正比关系。当管电压为120 kV,管电流为120 mA、100 mA、80 mA、50 mA组VHRCT和HRCT图像均能清楚显示小气道情况,图像噪声值无显著性差异(P>0.05)。管电流为20 mA时,VHRCT和HRCT均不能清楚显示小气道情况。
结论:①VHRCT图像显示肺内细小结构效果比标准重建图像好。②不同层厚的VHRCT图像中,0.625 mm的层厚显示肺内细小结构最好。③在管电流固定的条件下,容积扫描和传统HRCT扫描的辐射剂量与管电流呈正比。④VHRCT与HRCT图像噪声及显示肺内细小结构无明显差别,说明在不增加辐射剂量的前提下,宜选用VHRCT代替HRCT诊断肺小气道病变。⑤在管电压120 kV,管电流≥50 mA层厚为0.625 mm的VHRCT图像可显示儿童肺内细小结构。可将此方案作为显示小气道病变的优化扫描方案。
目的:回顾性分析117例儿童支原体肺炎64排CT胸部低剂量扫描VHRCT影像表现,研究儿童支原体肺炎VHRCT重建图像的小气道病变表现特点。
方法:对117例临床确诊的儿童支原体肺炎患儿行64排螺旋CT胸部低剂量扫描,管电压:120 kV,管电流:50 mA,容积数据行0.625 mm的VHRCT重建。
结果:117例患儿中,男77例,女40例,年龄6月～14岁,平均6.7岁±3.1岁。实变共93例,其中节段性叶实变影76例,伴支气管充气征34例,肺节段性部分性不张18例,小叶性实变17例;肺门或纵隔淋巴结肿大37例,胸腔积液36例;气胸3例;纵隔气肿2例。小气道的改变:树芽征59例,小叶中心结节影54例;磨玻璃影15例,马赛克灌注征11例,细支气管扩张26例。
结论:儿童支原体肺炎的薄层VHRCT重建图像主要表现为肺实变伴少量胸腔积液和淋巴结肿大;部分病人有小气道改变,主要表现为树芽征或小叶中心结节,可与大片实变并存,也可单独出现,其边缘较模糊、密度较低为特征性。薄层VHRCT重建图像对支原体肺炎小气道病变的诊断有重要价值。
Objective: Volume dates of children,s chest CT were used to study the differences of two different reconstruction algorithms and four reconstruction slice thickness in displaying the small airways. Structure of small airways were displayed in different radiation doses. And the optimization program,to display the small airways of lungs,was researched.
Methods:①Optimal thickness and optimal reconstruction algorithm: Volume datas of 200 patients with chest spiral CT (MSCT) were retrospectively analysised.VHRCT and standard algorithms were used to display the small airways in 0.625mm, 1.25mm, 2.5 mm and 5mm, respectively.And image quality of two algorithms and different thickness on the small bronchi of the left lung tip section were compared.②Dose selection: volume and conventional HRCT scan in lung phantom MSCT: tube voltage 120kV, tube current 120mA, 100 mA, 80 mA, 50mA, 20mA,respectively.Dose of two different scanning methods and different tube current and the image quality were compared between HRCT and VHRCT.
Results:①Two reconstruction algorithms and four different thickness were used to observe the small structure of small airway. In the same thickness, VHRCT shows a better image than the standard reconstruction to discover the bronchiole of left apical segment.In VHRCT , both 0.625mm and 1.25mm thickness can show the bronchiole of left apical segment clearly , there was no significant difference (P> 0.05),but the scores of 0.625mm was higher than 1.25mm, suggest that the best image display was 0.625mm.②In different tube currents, difference were studied between VHRCT and HRCT in 0.625mm:In the same tube currents,both MSCT and HRCT scan,there was a positive proportional relationship between CTDIw or DLP and the tube current. 120kV in the tube voltage, 120mA, 100 mA, 80 mA, 50mA in tube current , VHRCT and HRCT images can clearly show the situation of small airway, there was no significant difference (P> 0.05), both VHRCT and HRCT can not clearly display the small airway in 20mA of tube current.
Conclusion:①VHRCT is better than standard reconstruction to discover the small airway of lungs.②0.625mm is the best to discover the bronchiole in different thickness of VHRCT.③In the same tube current, there is a positive proportional relationship between radiation dose and MSCT or HRCT.④There is no significant difference to discover the small structure between VHRCT and HRCT, demostrate that VHRCT can replace HRCT to dignosis the disease of small airway ,without increasing the radiation dose .⑤In VHRCT, 120kV in tube voltage, more than 50mA in tube current and thickness in 0.625mm,small structure of lungs can be showed clearly.This program can be used as optimization strategy to display disease of small airway.
Objective:To explore the thin reconstruction of low-dose 64-slice CT in 117 children with mycoplasma pneumoniae pneumonia,to study small airway feature in the VHRCT of mycoplasma pneumonia.
Methods:117 children with mycoplasma pneumonia underwent low-dose64-slice chest CT scan, tube voltage: 120kV, tube current: 50mA, and volume HRCT reconstruction.
Results:The results of the thin reconstruction of low-dose 64-slice CT in 117 cases were as follows: Consolidation were observed in 93 cases, lobar or segmental consolidation were observed in 76 cases, which with bronchial inflatable sign in 34 cases and with mild volume decrease of the involved lobe in 18 cases; lobular consolidation were observed in 17 cases.
Lymphadenectasis were showed in 37 cases and pleural effusion were seen in 36 cases; pneumothorax and mediastinal emphysema were detected in 3 cases and 2 cases. Small airway changes: tree in bud was observed in 59 cases, centrilobular nodules in 54 cases, ground-glass shadow in 15 cases, mosaic perfusion syndrome in 11 cases and small bronchiectasis in 26 cases.
Conclusion:The main appearances of children with mycoplasma pneumoniae pneumonia are the tree-in-bud pattern or centrilobular nodules,which can appearence with consolidation The tree-in-bud pattern are vague of edges and low density. Thin reconstruction volume HRCT have a novel value in diagnosis of mycoplasma pneumoniae pneumonia in children.
引文
[1]李玉,薛玉文,吴大玮,王玲,许仁和.小气道病变患者小气道粘膜层免疫病理的变化.基础医学与临床.2004,24 (6):642-645.
[2] Sjostedt L,Willers,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and nonsensitized workers handling laboratory animals. J Dccup Environ Med.1998,40:118-124.
[3]王亚非,吴树春.64层螺旋CT多平面重组显示肺叶间裂.中华放射学杂志.2009,(7)43:817-821.
[4] Nishino M,Hatabu H. Volumtric expiratory HRCT imaging with MSCT. J Thorac Imaging, 2005, 20: 176-185.
[5] SunlikAwa H,Johkoh T,Koyama M,et al. Image quality of high-resolution CT with 16-channel multidetector-row CT;comparision between helical scan andconventional step-shoot scan.Radiat Med.2005, 23:539-544.
[6] Stueve D.Management of pediatric radiation dose using Philips fluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol.2006,36(Suppl 2):216-220.
[7] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues.J Am Coll Radiol.2004;1(2):113-9.
[8] Haaga JR. Radiation dose management: weighing risk versus benefit.AJR Am J Roentgenol.2001 Aug;177(2):289-91.
[1]李玉,薛玉文,吴大玮,王玲,许仁和.小气道病变患者小气道粘膜层免疫病理的变化.基础医学与临床.2004,24 (6):642-645.
[2] Sjostedt L,Willers,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and nonsensitized workers handling laboratory animals. J Dccup Environ Med.1998,40:118-124.
[3]温涛,段磊,蔡敏,岳园,等.低剂量容积数据高分辨率CT重组在肺部疾病中的应用价值.医学影像学杂志[J].2007,17(4):360-362.
[4] McCollough CH,Primak AN,Braun N,et al. Strategies for reducing radiati dose in CT.Radiol Clin Noah Am.2009,47 (1):27-40.
[5] Stueve D.Management of pediatric radiation dose using Philips fluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol.2006,36(Suppl 2):216-220.
[6] Sjostedt L,Willers S,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and non-sensitized workers handling laboratory animals.J occup Environ Med.1998,40(2):118-124.
[7]高燕莉,张镭,赵霞,等. 64层CT容积与常规高分辨率CT图像质量的比较.中华放射学杂志.2008,42(10):103-1034.
[8]王振光,马大庆,陈步东,等.容积数据高分辨率CT重组在弥漫性肺疾病中的应用.中华放射学杂志.2005,39(11):1153-1156.
[9] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues.J Am Coll Radiol.2004 Feb;1(2):113-119.
[10] Fraioli F,Catalano C,Almberger M,et a1.Evaluation of effectiveness of a computer system(CAD)in the identification of lung nodules with low-dose MSCT:scanning technique and preliminary results.Radi1 Med.2005,109(1-2):40-48.
[11] Picozzi G,Paci E,Lopez Pegna A,et a1.Screening of lung cancer with low dose spiral CT:results of a three year pilot study and design of the randomized controlled“ltalung-CT”.Radiol Med,2005,109(1-2):17-26.
[12] Kosucu P,Ahmetoglu A,Korarnaz I,et a1 . Low-dose MDST and Virtual Bronchoscopy in Pediatric Patients with foreign body aspiration . Am J Roentgenol.2004,183(6):1771—1777.
[13]干芸根,荣远新,李荫太,等.螺旋CT低剂量胸部扫描技术在儿童气管病变中的应用.中华放射医学与防护杂志.2006,26(4):405 407.
[14] Haaga JR. Radiation dose management: weighing risk versus benefit.AJR Am J Roentgenol.2001 Aug;177(2):289-91.
[15] Brenner DJ,Hall EJ.Computed tomography:An increasing Source of radiation Exposure[J].New England Journal of Med,2007,357(22):2277-2284.
[16]刘玥,彭芸,李剑颖,等.应用模拟低剂量法行新生儿头颅扫描.中华放射学杂志.2009,43(7):684-687.
[1]杨锡强,易著文.儿科学.北京:人民卫生出版社,2004:318.
[2] Waites KB,Talkington DF: Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev,2004,17:697-72.
[3]何玲,魏光辉,小气道疾病的影像学研究进展.重庆医学.2007,36(15)1548-1550.
[4]张晓晔,张伟,朱敏,等.成人支原体肺炎的CT表现.中国医学影像技术. 2007,23(7):1026-1029.
[5] Teel GS,Engeler CE,Tashijian JH,et a1.Imaging of small airway disese.Radiographise,1996,16(1):27.
[6] Reittner P,Muller NL,Heyneman L,et a1.M ycoplasma pneumoniae:radiographic and high resolution CT features in 28 patients.AJR,2000,174(1): 37-41.
[7] Fraser RS, Pare PJA, Fraser RG, et al. Synopsis of diseases of the chest, 2nd ed. Philadelphia:Saunders, 1994: 354–356.
[8] Inho Lee,Tae Sung Kim,Hye-Kyung Yoon.Mycoplasma pneumoniae pneumonia: CT features in 16 patients.Eur Radiol,2006,16: 719-725.
[9]陈志敏.儿童肺炎支原体感染诊治研究进展.临床儿科杂志.2008,26(7):562-565.
[10] Atsushi Nambu,Akitoshi Saito,Tsutomu Araki,et a1.Chlamydia Pneumoniae: Comparison with Findings of Mycoplasma Pneumoniae and Streptococcus Pneumoniae at Thin-Section CT.Radiology,2006,238(1):330-8.
[11]王新,冯立泉.小气道病变的HRCT诊断价值.中华现代影像学杂志.2007,23(7):1026-1029.
[12] Reittner P,Ward S,Heyneman L,et a1.Pneumonia:high-resolution CT findings in 114 patients.Eur Radiol, 2003,13(3):515-521.
[13] Kim CK,Chung CY,Kim JS,et al. Late abnormal findings on high-resolution computed tomography after mycoplasma pneumonia. Pediatrics, 2000, 105(2): 372-378.
[14]李鹤虹,罗良平.婴幼儿肺结核胸外播散的影像学表现.中国医学影像技术.2008,24(7):1025-1028.
[15]潘纪戌.高分辨率胸部CT.北京:人民军医出版社.2007:240.
[1]李玉,薛玉文,吴大玮,王玲,许仁和.小气道病变患者小气道粘膜层免疫病理的变化.基础医学与临床[J].2004,24 (6):642-645.
[2] Stueve D. Management of pediatric radiation dose using Philipsfluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol, 2006, 36(2): 216-220.
[3] haw RJ,Djukanovic R,Tashkin DP,et al.The role of small airways inlungdisease.Respir Med.2002,96(2):67-80.
[4]崔德健,曾泽戎.重视支气管哮喘小气道及肺组织病变.中华内科杂志.2001,40(3) :148-149.
[5]穆魁津,林友华.肺功能测定原理与临床应用.北京:北京医科大学中国协和医科大学联合出版社,1997.66—82.
[6]刘金玲,陈志敏.支气管肺泡灌洗在儿科中的应用进展.国外医学儿科学分册.2005,32(2):86-89.
[7] Sharma V, Shaaban AM, Berges G, et al.The radiological spectrum of small-airway diseases.Semin Ultrasound CT MR,2002,3(4):339-351.
[8] Verschakelen JA.Imaging of the Small airways.Semln Respir Cfit Care Med, 2003, 24(5): 473-488.
[9] Abbott GF, Rosado-de-Christenson ML, Rossi SE, et al.Imaging of small airways disease.J Thorac Imaging, 2009,24(4):285-298.
[10] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues. J Am Coll Radiol, 2004,1(2): 113-9.
[11] Haaga JR.Radiation dose management:weighing risk versus benefit. AJR Am J Roentgenol, 2001, 177(2): 289-91.
[12] Sjostedt L,Willers,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and nonsensitized workers handling laboratory animals.J Dccup Environ Med.1998,40:118-124.
[13]李一鸣,祁吉.慢性阻塞性肺疾病的CT研究进展.国外医学临床放射学分册. 2005,28(1):20-24.
[14] Nakano Y, Wong JC, de Jong PA, et al. The prediction of small airway dimensions using computed tomography. Am J Respir Crit Care Med 2005;171(2):142–146.
[15] McCollough cH,Primak AN,Braun N,et al.Strategies for reducing radiation dose in CT.Badiol Clin Noah Am,2009,47(1):27-40.
[16] Stueve D.Management of pediatric radiation dose using Philips fluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol.2006,36(Suppl 2):216—220.
[17] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues.J Am Coll Radiol.2004 Feb;1(2):113-9.
[18] Kosucu P,Ahmetoglu A,Korarnaz I,et a1.I OW—dose MDCT and Virtual Bronchoscopy in Pediatric Patients with Foreign Body As—piration .Am J Roentgenol.2004,183(6):1771—1777.
[19]干芸根,荣远新,李荫太,等.螺旋CT低剂量胸部扫描技术在儿童气管病变中的应用.中华放射医学与防护杂志.2006,26(4):405 407.
[20] Haaga JR. Radiation dose management: weighing risk versus benefit.AJR Am J Roentgenol.2001 Aug;177(2):289-91.
[21]王振光,马大庆.肺小叶结构的CT研究进展.国外医学临床放射学分册, 2005, 28(5): 328-330.
[22] Ley-Zaporozhan J, Ley S, Kauczor HU.Morphological and functional imaging in COPD with CT and MRI: present and future.Eur Radiol,2008,18(3): 510–521.
[23] Nishino M,Hatabu H. Volumtric expiratory HRCT imaging with MSCT.J Thorac Imaging,2005,20:176-185.
[24] SunlikAwa H,Johkoh T,Koyama M,et al. Image quality of high-resolution CT with 16-channel multidetector-row CT;comparision between helical scan and conventional step-shoot scan.Radiat Med.2005.23:539-544.
[25] Nishino M, Boiselle PM, Copeland JF, et al. Value of volumetric data acquisition in expiratory high-resolution computed tomography of the lung. J Comput As sist Tomogr, 2004, 28: 209 -214.
[26] Kelly DM, Hasegawa I, Borders R, et al. High-resolution CT us ing MDCT: comparison of degree of motion artifact between volumet ric and axial methods. AJR, 2004, 182: 757 -759.
[27]王振光,马大庆,陈步东,等.容积数据高分辨率CT重组在弥漫性肺疾病中的应用.中华放射学杂志.2005,39(11):1153-1156.
[28] SunlikAwa H,Johkoh T,Koyama M,et al. Image quality of high-resolution CT with 16-channel multidetector-row CT;comparision between helical scan and conventional step-shoot scan.Radiat Med.2005.23:539-544.
[29]高燕莉,张镭,赵霞,等. 64层CT容积与常规高分辨率CT图像质量的比较.中华放射学杂志.2008,42(10):103-1034.
[30]王亚非,吴树春.64层螺旋CT多平面重组显示肺叶间裂.中华放射学杂志, 2009, 43(8): 817-821.
[31] Hasegawa M,Nasuhara Y,Onodera Y,et al.Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2006, 173(12): 1309–1315.
[32] Chooi WK,Matthews S,Bull MJ,et al.Multislice computed tomography in staging lung cancer: the role of multiplanar image reconstruction.J Comput Assist Tomogr, 2005,29(3):357-360.
[33] Chooi WK, Matthews S, Bull MJ,et al.Multislice helical CT: the value of multiplanar image reconstruction in assessment of the bronchi and small airways disease.Br J Radiol, 2003,76(908):536-540.
[34] Screaton NJ, Hiorns MP , Müller NL. Differential diagnosis in chronic diffuse infiltrative lung disease on high-resolution computed tomography. Semin Roentgenol, 2002 , 37(1): 17-24.
[35] Gruden JF, Ouanounou S, Tigges S, et al. Incremental benefit of maximum-intensity-projection images on observer detection of small pulmonary nodules revealed by multidetector CT. AJR Am J Roentgenol, 2002, 179(1): 149-57.
[36] Stoel BC, Stolk J.Optimization and standardization of lung densitometry in the assessment of pulmonary emphysema. Invest Radiol,2004,39(11):681-688.
[37] Madani A, Zanen J, de Maertelaer V,Gevenois PA.Pulmonary emphysema: objective quantification at multi-detector row CT-comparison with macroscopic and microscopic morphometry. Radiology, 2006,238(3): 1036-43.
[38] Pipavath SJ, Lynch DA, Cool C, et al. Radiologic and pathologic features of bronchiolitis. AJR Am J Roentgenol,2005,185(2):354-363.
[39] Pipavath SN, Stern EJ.Imaging of Small Airway Disease (SAD). Radiol Clin North Am,2009,47(2):307-316.
[40]王振光,马大庆.气道影像学-功能成像与影像评价.人民军医出版社,2009:144.
[41]关文华,韩铭均,张晶.肺结核支气管播散的MSCT影像学特征及其与血清胆固醇浓度的关系.放射学实践,2009,24(8):847-849.
[42]潘纪戌.高分辨率肺部CT.北京:人民军医出版社.2007:240-241.
[43]陈育智.儿童支气管哮喘的诊断及治疗.北京:人民卫生出版社,2004,1.
[44] Gono H,Fujimoto K,Kawakami S,et a1.Evaluation of airway wall thickness andair trapping by HRCT in asymptomatic asthma.Eur Respir J,2003,22(6) :965-971.
[45] Keieho N,Kudoh S.Diffuse panbmnchiolitis :role of macrolides in therapy.Am J Respir Med,2002,1(2) :119-131.
[46] Anita Bhandari ,Vineet Bhandari1 .Bronchopulmonary Dysplasia.An Update Indian J Pediatr ,2007,74 (1):73-77.
[2] Sjostedt L,Willers,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and nonsensitized workers handling laboratory animals. J Dccup Environ Med.1998,40:118-124.
[3]王亚非,吴树春.64层螺旋CT多平面重组显示肺叶间裂.中华放射学杂志.2009,(7)43:817-821.
[4] Nishino M,Hatabu H. Volumtric expiratory HRCT imaging with MSCT. J Thorac Imaging, 2005, 20: 176-185.
[5] SunlikAwa H,Johkoh T,Koyama M,et al. Image quality of high-resolution CT with 16-channel multidetector-row CT;comparision between helical scan andconventional step-shoot scan.Radiat Med.2005, 23:539-544.
[6] Stueve D.Management of pediatric radiation dose using Philips fluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol.2006,36(Suppl 2):216-220.
[7] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues.J Am Coll Radiol.2004;1(2):113-9.
[8] Haaga JR. Radiation dose management: weighing risk versus benefit.AJR Am J Roentgenol.2001 Aug;177(2):289-91.
[1]李玉,薛玉文,吴大玮,王玲,许仁和.小气道病变患者小气道粘膜层免疫病理的变化.基础医学与临床.2004,24 (6):642-645.
[2] Sjostedt L,Willers,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and nonsensitized workers handling laboratory animals. J Dccup Environ Med.1998,40:118-124.
[3]温涛,段磊,蔡敏,岳园,等.低剂量容积数据高分辨率CT重组在肺部疾病中的应用价值.医学影像学杂志[J].2007,17(4):360-362.
[4] McCollough CH,Primak AN,Braun N,et al. Strategies for reducing radiati dose in CT.Radiol Clin Noah Am.2009,47 (1):27-40.
[5] Stueve D.Management of pediatric radiation dose using Philips fluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol.2006,36(Suppl 2):216-220.
[6] Sjostedt L,Willers S,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and non-sensitized workers handling laboratory animals.J occup Environ Med.1998,40(2):118-124.
[7]高燕莉,张镭,赵霞,等. 64层CT容积与常规高分辨率CT图像质量的比较.中华放射学杂志.2008,42(10):103-1034.
[8]王振光,马大庆,陈步东,等.容积数据高分辨率CT重组在弥漫性肺疾病中的应用.中华放射学杂志.2005,39(11):1153-1156.
[9] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues.J Am Coll Radiol.2004 Feb;1(2):113-119.
[10] Fraioli F,Catalano C,Almberger M,et a1.Evaluation of effectiveness of a computer system(CAD)in the identification of lung nodules with low-dose MSCT:scanning technique and preliminary results.Radi1 Med.2005,109(1-2):40-48.
[11] Picozzi G,Paci E,Lopez Pegna A,et a1.Screening of lung cancer with low dose spiral CT:results of a three year pilot study and design of the randomized controlled“ltalung-CT”.Radiol Med,2005,109(1-2):17-26.
[12] Kosucu P,Ahmetoglu A,Korarnaz I,et a1 . Low-dose MDST and Virtual Bronchoscopy in Pediatric Patients with foreign body aspiration . Am J Roentgenol.2004,183(6):1771—1777.
[13]干芸根,荣远新,李荫太,等.螺旋CT低剂量胸部扫描技术在儿童气管病变中的应用.中华放射医学与防护杂志.2006,26(4):405 407.
[14] Haaga JR. Radiation dose management: weighing risk versus benefit.AJR Am J Roentgenol.2001 Aug;177(2):289-91.
[15] Brenner DJ,Hall EJ.Computed tomography:An increasing Source of radiation Exposure[J].New England Journal of Med,2007,357(22):2277-2284.
[16]刘玥,彭芸,李剑颖,等.应用模拟低剂量法行新生儿头颅扫描.中华放射学杂志.2009,43(7):684-687.
[1]杨锡强,易著文.儿科学.北京:人民卫生出版社,2004:318.
[2] Waites KB,Talkington DF: Mycoplasma pneumoniae and its role as a human pathogen. Clin Microbiol Rev,2004,17:697-72.
[3]何玲,魏光辉,小气道疾病的影像学研究进展.重庆医学.2007,36(15)1548-1550.
[4]张晓晔,张伟,朱敏,等.成人支原体肺炎的CT表现.中国医学影像技术. 2007,23(7):1026-1029.
[5] Teel GS,Engeler CE,Tashijian JH,et a1.Imaging of small airway disese.Radiographise,1996,16(1):27.
[6] Reittner P,Muller NL,Heyneman L,et a1.M ycoplasma pneumoniae:radiographic and high resolution CT features in 28 patients.AJR,2000,174(1): 37-41.
[7] Fraser RS, Pare PJA, Fraser RG, et al. Synopsis of diseases of the chest, 2nd ed. Philadelphia:Saunders, 1994: 354–356.
[8] Inho Lee,Tae Sung Kim,Hye-Kyung Yoon.Mycoplasma pneumoniae pneumonia: CT features in 16 patients.Eur Radiol,2006,16: 719-725.
[9]陈志敏.儿童肺炎支原体感染诊治研究进展.临床儿科杂志.2008,26(7):562-565.
[10] Atsushi Nambu,Akitoshi Saito,Tsutomu Araki,et a1.Chlamydia Pneumoniae: Comparison with Findings of Mycoplasma Pneumoniae and Streptococcus Pneumoniae at Thin-Section CT.Radiology,2006,238(1):330-8.
[11]王新,冯立泉.小气道病变的HRCT诊断价值.中华现代影像学杂志.2007,23(7):1026-1029.
[12] Reittner P,Ward S,Heyneman L,et a1.Pneumonia:high-resolution CT findings in 114 patients.Eur Radiol, 2003,13(3):515-521.
[13] Kim CK,Chung CY,Kim JS,et al. Late abnormal findings on high-resolution computed tomography after mycoplasma pneumonia. Pediatrics, 2000, 105(2): 372-378.
[14]李鹤虹,罗良平.婴幼儿肺结核胸外播散的影像学表现.中国医学影像技术.2008,24(7):1025-1028.
[15]潘纪戌.高分辨率胸部CT.北京:人民军医出版社.2007:240.
[1]李玉,薛玉文,吴大玮,王玲,许仁和.小气道病变患者小气道粘膜层免疫病理的变化.基础医学与临床[J].2004,24 (6):642-645.
[2] Stueve D. Management of pediatric radiation dose using Philipsfluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol, 2006, 36(2): 216-220.
[3] haw RJ,Djukanovic R,Tashkin DP,et al.The role of small airways inlungdisease.Respir Med.2002,96(2):67-80.
[4]崔德健,曾泽戎.重视支气管哮喘小气道及肺组织病变.中华内科杂志.2001,40(3) :148-149.
[5]穆魁津,林友华.肺功能测定原理与临床应用.北京:北京医科大学中国协和医科大学联合出版社,1997.66—82.
[6]刘金玲,陈志敏.支气管肺泡灌洗在儿科中的应用进展.国外医学儿科学分册.2005,32(2):86-89.
[7] Sharma V, Shaaban AM, Berges G, et al.The radiological spectrum of small-airway diseases.Semin Ultrasound CT MR,2002,3(4):339-351.
[8] Verschakelen JA.Imaging of the Small airways.Semln Respir Cfit Care Med, 2003, 24(5): 473-488.
[9] Abbott GF, Rosado-de-Christenson ML, Rossi SE, et al.Imaging of small airways disease.J Thorac Imaging, 2009,24(4):285-298.
[10] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues. J Am Coll Radiol, 2004,1(2): 113-9.
[11] Haaga JR.Radiation dose management:weighing risk versus benefit. AJR Am J Roentgenol, 2001, 177(2): 289-91.
[12] Sjostedt L,Willers,Orbaek P,el a1.A seven-year follow-up study of lung function and methacholine responsiveness in sensitized and nonsensitized workers handling laboratory animals.J Dccup Environ Med.1998,40:118-124.
[13]李一鸣,祁吉.慢性阻塞性肺疾病的CT研究进展.国外医学临床放射学分册. 2005,28(1):20-24.
[14] Nakano Y, Wong JC, de Jong PA, et al. The prediction of small airway dimensions using computed tomography. Am J Respir Crit Care Med 2005;171(2):142–146.
[15] McCollough cH,Primak AN,Braun N,et al.Strategies for reducing radiation dose in CT.Badiol Clin Noah Am,2009,47(1):27-40.
[16] Stueve D.Management of pediatric radiation dose using Philips fluoroscopy systems Dose Wise:perfect image,perfect sense.Pediatr Radiol.2006,36(Suppl 2):216—220.
[17] Frush DP, Applegate K. Computed tomography and radiation: understanding the issues.J Am Coll Radiol.2004 Feb;1(2):113-9.
[18] Kosucu P,Ahmetoglu A,Korarnaz I,et a1.I OW—dose MDCT and Virtual Bronchoscopy in Pediatric Patients with Foreign Body As—piration .Am J Roentgenol.2004,183(6):1771—1777.
[19]干芸根,荣远新,李荫太,等.螺旋CT低剂量胸部扫描技术在儿童气管病变中的应用.中华放射医学与防护杂志.2006,26(4):405 407.
[20] Haaga JR. Radiation dose management: weighing risk versus benefit.AJR Am J Roentgenol.2001 Aug;177(2):289-91.
[21]王振光,马大庆.肺小叶结构的CT研究进展.国外医学临床放射学分册, 2005, 28(5): 328-330.
[22] Ley-Zaporozhan J, Ley S, Kauczor HU.Morphological and functional imaging in COPD with CT and MRI: present and future.Eur Radiol,2008,18(3): 510–521.
[23] Nishino M,Hatabu H. Volumtric expiratory HRCT imaging with MSCT.J Thorac Imaging,2005,20:176-185.
[24] SunlikAwa H,Johkoh T,Koyama M,et al. Image quality of high-resolution CT with 16-channel multidetector-row CT;comparision between helical scan and conventional step-shoot scan.Radiat Med.2005.23:539-544.
[25] Nishino M, Boiselle PM, Copeland JF, et al. Value of volumetric data acquisition in expiratory high-resolution computed tomography of the lung. J Comput As sist Tomogr, 2004, 28: 209 -214.
[26] Kelly DM, Hasegawa I, Borders R, et al. High-resolution CT us ing MDCT: comparison of degree of motion artifact between volumet ric and axial methods. AJR, 2004, 182: 757 -759.
[27]王振光,马大庆,陈步东,等.容积数据高分辨率CT重组在弥漫性肺疾病中的应用.中华放射学杂志.2005,39(11):1153-1156.
[28] SunlikAwa H,Johkoh T,Koyama M,et al. Image quality of high-resolution CT with 16-channel multidetector-row CT;comparision between helical scan and conventional step-shoot scan.Radiat Med.2005.23:539-544.
[29]高燕莉,张镭,赵霞,等. 64层CT容积与常规高分辨率CT图像质量的比较.中华放射学杂志.2008,42(10):103-1034.
[30]王亚非,吴树春.64层螺旋CT多平面重组显示肺叶间裂.中华放射学杂志, 2009, 43(8): 817-821.
[31] Hasegawa M,Nasuhara Y,Onodera Y,et al.Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med, 2006, 173(12): 1309–1315.
[32] Chooi WK,Matthews S,Bull MJ,et al.Multislice computed tomography in staging lung cancer: the role of multiplanar image reconstruction.J Comput Assist Tomogr, 2005,29(3):357-360.
[33] Chooi WK, Matthews S, Bull MJ,et al.Multislice helical CT: the value of multiplanar image reconstruction in assessment of the bronchi and small airways disease.Br J Radiol, 2003,76(908):536-540.
[34] Screaton NJ, Hiorns MP , Müller NL. Differential diagnosis in chronic diffuse infiltrative lung disease on high-resolution computed tomography. Semin Roentgenol, 2002 , 37(1): 17-24.
[35] Gruden JF, Ouanounou S, Tigges S, et al. Incremental benefit of maximum-intensity-projection images on observer detection of small pulmonary nodules revealed by multidetector CT. AJR Am J Roentgenol, 2002, 179(1): 149-57.
[36] Stoel BC, Stolk J.Optimization and standardization of lung densitometry in the assessment of pulmonary emphysema. Invest Radiol,2004,39(11):681-688.
[37] Madani A, Zanen J, de Maertelaer V,Gevenois PA.Pulmonary emphysema: objective quantification at multi-detector row CT-comparison with macroscopic and microscopic morphometry. Radiology, 2006,238(3): 1036-43.
[38] Pipavath SJ, Lynch DA, Cool C, et al. Radiologic and pathologic features of bronchiolitis. AJR Am J Roentgenol,2005,185(2):354-363.
[39] Pipavath SN, Stern EJ.Imaging of Small Airway Disease (SAD). Radiol Clin North Am,2009,47(2):307-316.
[40]王振光,马大庆.气道影像学-功能成像与影像评价.人民军医出版社,2009:144.
[41]关文华,韩铭均,张晶.肺结核支气管播散的MSCT影像学特征及其与血清胆固醇浓度的关系.放射学实践,2009,24(8):847-849.
[42]潘纪戌.高分辨率肺部CT.北京:人民军医出版社.2007:240-241.
[43]陈育智.儿童支气管哮喘的诊断及治疗.北京:人民卫生出版社,2004,1.
[44] Gono H,Fujimoto K,Kawakami S,et a1.Evaluation of airway wall thickness andair trapping by HRCT in asymptomatic asthma.Eur Respir J,2003,22(6) :965-971.
[45] Keieho N,Kudoh S.Diffuse panbmnchiolitis :role of macrolides in therapy.Am J Respir Med,2002,1(2) :119-131.
[46] Anita Bhandari ,Vineet Bhandari1 .Bronchopulmonary Dysplasia.An Update Indian J Pediatr ,2007,74 (1):73-77.