多层螺旋CT在眼眶正常解剖中的应用
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摘要
目的
①探讨多层螺旋CT后处理技术在眶骨正常相关结构中的应用及标准断面图像在对称显示眼眶相关结构中的优势。②探讨降低管电压在减少眼眶CT扫描辐射剂量中的可行性。
材料与方法
①收集207例无眼眶外伤史的被检者的眶部多层螺旋CT图像,对常规扫描断面图像与经MRP重建的标准断面图像对眼眶正常相关结构的对称显示情况进行对比研究及统计学分析,同时结合多种后处理技术。②另外对40例(80个眼眶)无眼眶外伤史的被检者随机分为两组,每组各20例(40个眼眶),分别进行标准条件(120Kv,100mA)和低剂量条件(100Kv,100mA)CT扫描,并对所得图像均行1.51mm、3.Omm薄层重建,层间距分别为1.Omm、2.Omm。比较不同管电压的容积CT剂量指数(CTDIvo1)、图像质量及图像噪声的差别。
结果
①重组后的标准化图像在双侧眼眶相关结构的对称性显示中较常规扫描图像更有优势,更有利于临床诊断。结合VR、CPR等后处理技术更能立体、直观地观察眼眶细微结构的全貌。本研究结果显示,标准轴位图像对颧额缝、颧骨管、眶下管、眶上切迹、视神经管及晶状体的对称性显示明显优于常规扫描轴位图像(P<0.01)；而两者对颧蝶缝的对称性显示无显著差异(P>0.05)。②管电压100Kv时与常规剂量(120Kv)比较,CTDIvol减低,即辐射剂量有所下降。本研究结果显示,两组间相应层厚图像噪声大小间都存在统计学差别(P<0.01),100Kv扫描的图像噪声均较120Kv大。虽然低Kv扫描图像噪声有所增加,但图像能够清楚显示眼环、眼直肌、视神经及晶状体等眶内各结构及眶壁骨质,图像质量与常规剂量扫描图像相比无显著差异(P>0.05)。
结论
①多层螺旋CT后处理技术在显示眼眶正常相关结构中有重要意义和优势,经MPR重建的标准轴位图像能够很好地对称显示双侧眼眶的相关结构,这对病变的定位和定性都有重要的意义。观察标准化图像在减轻影像医生的阅片量的同时,也提高了诊断准确率。同时,结合VR、CPR等后处理技术更能立体、直观地观察眼眶细微结构的全貌。②降低管电压(100Kv)对眼眶行CT扫描,虽然图像噪声有所增加,但是图像质量与常规剂量相比无明显差异,能满足临床诊断要求,并降低了被检者的辐射剂量。它是降低管电流之外的,另一种降低辐射剂量的可行方法
Purpose
①To explore the value of post-processing techniques of multi-slice spiral CT(MSCT) in normal orbital related structures,and the advantages of standard axle bits image in showing the normal orbital related structures symmetrically.②To explore the possibility of Low-Kilovoltage CT Scanning in orbit.
Material and Methods
①207cases with the source images of no orbital trauma history were retrospectively reviewed.The show results of conventional axel bits image and standard axle bits image after MPR reconstrution were compared and statistical analysed, also using other post-processing techniques.②In addition,forty cases(eighty orbits) of no orbital trauma history were divided into tow groups randomly,each group contains twenty cases (forty orbits).One group were scanned routinely(120Kv,100mA),and the other group was scanned with Low-Kilovoltage(100Kv,100mA).The image was reconstructed into 1.5mm and 3.0mm.The layer spacing was respectively 1.0mm and 2.0mm. The CTDvol, image quality and image noise were respectively compared between different tube voltage.
Result
①The standard axle bits image afer MPR reconstrution was better than conventional axel bits image in showing the orbital related structures symmetrically,and it was more advantageous to the clinical diagnosis.Combining VR,CPR,etc post-processing techniques,it can show the whole subtle orbital structures stereoscopically and intuitively. The display rate of sutura nygomaticofrontalis,the canal of temporal bone,infraorbital canal,supraorbital notch,optic canal,and crystalline lens in the standard section was significantly higher than in conventional images(P< 0.01);.There were no difference in the display rate of the sutura zygomaticosphenoidalis(P>0.05).②Comparing the conventional scanning(120Kv),the CTDvol of 100Kv is smaller,that means the radiation dosage become lower. The study showed that, there was difference between different thickness (P<0.01).The image noise of 100Kv was higher than 120Kv.Although the image noise become higher, the image of Low-Kilovoltage can show the intraorbital structures clealy,such as eye ring, eye mustle,optic nerve,crystalline lens and orbital wall. Comparing the conventional scanning,there was no difference in image quality(P>0.05).
Conclusion
①The post-processing techniques of multi-slice spiral CT(MSCT) has significant meanings and advantages in showing the orbital related structures. The standard axle bits after MPR reconstrution image can show the both sides orbital structures symmetrically.lt is very important for the focus'positioning and qualitative dignosis.It can reduce the doctors' reading quantity and improve the dignosis accurancy to analy the standard images. Combining VR,CPR,etc post-processing techniques,it can show the whole subtle orbital structures stereoscopically and intuitively.②Though the image noise of Low-Kilovoltage CT Scanning(100Kv) increased, there was no difference in image quality,comparing the conventional scanning.lt can meet t the requirements of clinical diagnosis,and it's an another avaliable method to reduce the radiation dosage,besides lessening the current.
①探讨多层螺旋CT后处理技术在眶骨正常相关结构中的应用及标准断面图像在对称显示眼眶相关结构中的优势。②探讨降低管电压在减少眼眶CT扫描辐射剂量中的可行性。
材料与方法
①收集207例无眼眶外伤史的被检者的眶部多层螺旋CT图像,对常规扫描断面图像与经MRP重建的标准断面图像对眼眶正常相关结构的对称显示情况进行对比研究及统计学分析,同时结合多种后处理技术。②另外对40例(80个眼眶)无眼眶外伤史的被检者随机分为两组,每组各20例(40个眼眶),分别进行标准条件(120Kv,100mA)和低剂量条件(100Kv,100mA)CT扫描,并对所得图像均行1.51mm、3.Omm薄层重建,层间距分别为1.Omm、2.Omm。比较不同管电压的容积CT剂量指数(CTDIvo1)、图像质量及图像噪声的差别。
结果
①重组后的标准化图像在双侧眼眶相关结构的对称性显示中较常规扫描图像更有优势,更有利于临床诊断。结合VR、CPR等后处理技术更能立体、直观地观察眼眶细微结构的全貌。本研究结果显示,标准轴位图像对颧额缝、颧骨管、眶下管、眶上切迹、视神经管及晶状体的对称性显示明显优于常规扫描轴位图像(P<0.01)；而两者对颧蝶缝的对称性显示无显著差异(P>0.05)。②管电压100Kv时与常规剂量(120Kv)比较,CTDIvol减低,即辐射剂量有所下降。本研究结果显示,两组间相应层厚图像噪声大小间都存在统计学差别(P<0.01),100Kv扫描的图像噪声均较120Kv大。虽然低Kv扫描图像噪声有所增加,但图像能够清楚显示眼环、眼直肌、视神经及晶状体等眶内各结构及眶壁骨质,图像质量与常规剂量扫描图像相比无显著差异(P>0.05)。
结论
①多层螺旋CT后处理技术在显示眼眶正常相关结构中有重要意义和优势,经MPR重建的标准轴位图像能够很好地对称显示双侧眼眶的相关结构,这对病变的定位和定性都有重要的意义。观察标准化图像在减轻影像医生的阅片量的同时,也提高了诊断准确率。同时,结合VR、CPR等后处理技术更能立体、直观地观察眼眶细微结构的全貌。②降低管电压(100Kv)对眼眶行CT扫描,虽然图像噪声有所增加,但是图像质量与常规剂量相比无明显差异,能满足临床诊断要求,并降低了被检者的辐射剂量。它是降低管电流之外的,另一种降低辐射剂量的可行方法
Purpose
①To explore the value of post-processing techniques of multi-slice spiral CT(MSCT) in normal orbital related structures,and the advantages of standard axle bits image in showing the normal orbital related structures symmetrically.②To explore the possibility of Low-Kilovoltage CT Scanning in orbit.
Material and Methods
①207cases with the source images of no orbital trauma history were retrospectively reviewed.The show results of conventional axel bits image and standard axle bits image after MPR reconstrution were compared and statistical analysed, also using other post-processing techniques.②In addition,forty cases(eighty orbits) of no orbital trauma history were divided into tow groups randomly,each group contains twenty cases (forty orbits).One group were scanned routinely(120Kv,100mA),and the other group was scanned with Low-Kilovoltage(100Kv,100mA).The image was reconstructed into 1.5mm and 3.0mm.The layer spacing was respectively 1.0mm and 2.0mm. The CTDvol, image quality and image noise were respectively compared between different tube voltage.
Result
①The standard axle bits image afer MPR reconstrution was better than conventional axel bits image in showing the orbital related structures symmetrically,and it was more advantageous to the clinical diagnosis.Combining VR,CPR,etc post-processing techniques,it can show the whole subtle orbital structures stereoscopically and intuitively. The display rate of sutura nygomaticofrontalis,the canal of temporal bone,infraorbital canal,supraorbital notch,optic canal,and crystalline lens in the standard section was significantly higher than in conventional images(P< 0.01);.There were no difference in the display rate of the sutura zygomaticosphenoidalis(P>0.05).②Comparing the conventional scanning(120Kv),the CTDvol of 100Kv is smaller,that means the radiation dosage become lower. The study showed that, there was difference between different thickness (P<0.01).The image noise of 100Kv was higher than 120Kv.Although the image noise become higher, the image of Low-Kilovoltage can show the intraorbital structures clealy,such as eye ring, eye mustle,optic nerve,crystalline lens and orbital wall. Comparing the conventional scanning,there was no difference in image quality(P>0.05).
Conclusion
①The post-processing techniques of multi-slice spiral CT(MSCT) has significant meanings and advantages in showing the orbital related structures. The standard axle bits after MPR reconstrution image can show the both sides orbital structures symmetrically.lt is very important for the focus'positioning and qualitative dignosis.It can reduce the doctors' reading quantity and improve the dignosis accurancy to analy the standard images. Combining VR,CPR,etc post-processing techniques,it can show the whole subtle orbital structures stereoscopically and intuitively.②Though the image noise of Low-Kilovoltage CT Scanning(100Kv) increased, there was no difference in image quality,comparing the conventional scanning.lt can meet t the requirements of clinical diagnosis,and it's an another avaliable method to reduce the radiation dosage,besides lessening the current.
引文
1.Bursali A,Arac M,Oner AY,etal.Evalaution of the normal appendix at low-dose non-enhanced spiral CT[J].Diagn Interv Radiol,205,11(1):45-50.
2.任庆云,何杰,王大军,等,副鼻窦低剂量CT扫描的临床研究[J].中国辐射卫生,2005,14(2)119-121.
3.顾小容,张兰芳,沈文荣,低Kv多层螺旋CT扫描技术的胸部应用[J].,江苏医药,2007,33(12)：1289-1290.
4.孟聪.多排螺旋CT眼眶低剂量扫描的临床应用研究[D].中国优秀硕士学位论文全文数据库,2009,,(11)
5邹晓凤,柳澄,王道才,等.多层螺旋CT在鼻窦及其相关结构检查中的应用[J].中国中西医结合影像学杂志,2007,5(2)：99-105.
6.Rosengthal E,Quint DJ,John M.et al.Diagnostic maxilla facial coronal images reformatted from helical acquired thin section axial CT data[J].AJR,2000,175(4):1177-1181.
7.刘凯,柳澄,陈青华等.颞骨高分辨率CT各向同性的研究[J].中华放射学杂志,2005,39(1)：96-100.
8.Zilkha A. Computed tomography of blow—out fracture of the medial orbital wall [J].AJR,1981,137:963.
9. Heath, D. G., et al. Three-dimensional spiral CT during arte rial portography: comparison of three rendering t echniques. Radiographics,1995,15(4):1001-1011
10.程钢炜,赵家良,牟文斌,等,国人视神经管新一代三维重建的效果分析[J].中国实用眼科杂志,2005,23(8)：787-791.
1.Ron E,Lubin JH,Shore RE,et al.Thyroid cancer after exposure to external radiation:apooled analysis of sevens tudies[J].Radiat Res,1995,141:259.277
2.Shore RE.Issues and epidemiological evidence ergarding radation-induced thyroid cancer[J].Radiat Res,1999,131:98-111
3.介入放射学继续教育.并发症防治及辐射防护研讨会汇编.中国昆明,1999,9,13.
4.孟聪.多排螺旋CT眼眶低剂量扫描的临床应用研究[D].中国优秀硕士学位论文全文数据库,2009,(11)
5.王刚,白艳,向建斯,等,眼眶部低剂量CT扫描的辐射防护[J].实用放射学杂志,2007,,23(7)
6.张哲宝.医学影像物理学[M].第2版.北京：人民卫生出版社.2006,44
7.Bursali A,Arac M,Oner AY,etal.Evalaution of the normal appendix at low-dose non-enhanced spiral CT[J].Diagn Interv Radiol,205,11(1):45-50.
8.杨珂,吴建,李福生,等,CT剂量指数(CTDI)的使用[J].中国辐射卫生.2005,14(1).76-77.
9.Kalar MK,Mzther MM,Toth TL,et al.Strategies for CT radiation dose optimization.Radiology,2004,230:619-628
10.顾小容,张兰芳,沈文荣,低Kv多层螺旋CT扫描技术的胸部应用[J].,江苏医药,2007,33(12)：1289-1290
11.王秋霞,万常华,陈亮,等,64层螺旋CT检测泌尿系结石低kV扫描的优化选择及临床应用[J].放射学实践,2010,,25(15)；1157-1160
12.林飞飞,千芸根,曾洪武,等,螺旋CT低剂量扫描对小儿肘关节外伤的诊断价值[J].中国CT和MRI杂志,2010,8(3)：71-73
1.汪芳润,周晓东,周世铮,等.眼球径线CT测定与屈光的关系.中华眼科杂志,1994,30：39
2.Takei K, Stekine I, Okamoto F,et al. Measurement of axial length of eyes with incomplete filling of silicone oil in the vitrous cavity using X-ray computed tomography. Britain Journal of Opthalmol,2002,86:47
3.鄢广平,郑晓华,谢宝君,等,成人眼球结构的螺旋CT测量[J],临床放射学杂志,2004,23(6)
4.韩永顺,叶强,余强,等,正常成人骨性眶距三维测量[J].中国临床医学,2008,15(5)：702-704.
5.程钢炜,赵家良,牟文斌,等,国人视神经管新一代三维重建的效果分析[J].中国实用眼科杂志,2005,23(8)：787-791.
6. Heath, D. G., et al. Three-dimensional spiral CT during arte rial portography: comparison of three rendering t echniques. Radiographics,1995,15 (4):1001-1011
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13.张哲宝.医学影像物理学[M].第2版.北京：人民卫生出版社.2006,44
14.Ron E,Lubin JH,Shore RE,et al.Thyroid cancer after exposure to external radiation:apooled analysis of seven studies [J].Radiat Res,1995,141:259.277
15.Shore RE.lssues and epidemiological evidence ergarding radation-induced thyroid cancer[J].Radiat Res,1999,131:98-111
16.介入放射学继续教育.并发症防治及辐射防护研讨会汇编.中国昆明,1999,9,13.
17.Bursali A.Arac M,Oner AY,etal.Evalaution of the normal appendix at low-dose non-enhanced spiral CT[J].Diagn Interv Radiol,205,1(1):45-50.
18.杨珂,吴建,李福生,等,CT剂量指数(CTDI)的使用[J].中国辐射卫生.2005,14(1).76-77.
19.杨智云,头颅五官多层螺旋CT扫描辐射剂量研究.全国CT低剂量研讨会论文汇编.中国广州.2008,6,11
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21.孟聪.多排螺旋CT眼眶低剂量扫描的临床应用研究[D].中国优秀硕士学位论文全文数据库,2009,(11)
2.任庆云,何杰,王大军,等,副鼻窦低剂量CT扫描的临床研究[J].中国辐射卫生,2005,14(2)119-121.
3.顾小容,张兰芳,沈文荣,低Kv多层螺旋CT扫描技术的胸部应用[J].,江苏医药,2007,33(12)：1289-1290.
4.孟聪.多排螺旋CT眼眶低剂量扫描的临床应用研究[D].中国优秀硕士学位论文全文数据库,2009,,(11)
5邹晓凤,柳澄,王道才,等.多层螺旋CT在鼻窦及其相关结构检查中的应用[J].中国中西医结合影像学杂志,2007,5(2)：99-105.
6.Rosengthal E,Quint DJ,John M.et al.Diagnostic maxilla facial coronal images reformatted from helical acquired thin section axial CT data[J].AJR,2000,175(4):1177-1181.
7.刘凯,柳澄,陈青华等.颞骨高分辨率CT各向同性的研究[J].中华放射学杂志,2005,39(1)：96-100.
8.Zilkha A. Computed tomography of blow—out fracture of the medial orbital wall [J].AJR,1981,137:963.
9. Heath, D. G., et al. Three-dimensional spiral CT during arte rial portography: comparison of three rendering t echniques. Radiographics,1995,15(4):1001-1011
10.程钢炜,赵家良,牟文斌,等,国人视神经管新一代三维重建的效果分析[J].中国实用眼科杂志,2005,23(8)：787-791.
1.Ron E,Lubin JH,Shore RE,et al.Thyroid cancer after exposure to external radiation:apooled analysis of sevens tudies[J].Radiat Res,1995,141:259.277
2.Shore RE.Issues and epidemiological evidence ergarding radation-induced thyroid cancer[J].Radiat Res,1999,131:98-111
3.介入放射学继续教育.并发症防治及辐射防护研讨会汇编.中国昆明,1999,9,13.
4.孟聪.多排螺旋CT眼眶低剂量扫描的临床应用研究[D].中国优秀硕士学位论文全文数据库,2009,(11)
5.王刚,白艳,向建斯,等,眼眶部低剂量CT扫描的辐射防护[J].实用放射学杂志,2007,,23(7)
6.张哲宝.医学影像物理学[M].第2版.北京：人民卫生出版社.2006,44
7.Bursali A,Arac M,Oner AY,etal.Evalaution of the normal appendix at low-dose non-enhanced spiral CT[J].Diagn Interv Radiol,205,11(1):45-50.
8.杨珂,吴建,李福生,等,CT剂量指数(CTDI)的使用[J].中国辐射卫生.2005,14(1).76-77.
9.Kalar MK,Mzther MM,Toth TL,et al.Strategies for CT radiation dose optimization.Radiology,2004,230:619-628
10.顾小容,张兰芳,沈文荣,低Kv多层螺旋CT扫描技术的胸部应用[J].,江苏医药,2007,33(12)：1289-1290
11.王秋霞,万常华,陈亮,等,64层螺旋CT检测泌尿系结石低kV扫描的优化选择及临床应用[J].放射学实践,2010,,25(15)；1157-1160
12.林飞飞,千芸根,曾洪武,等,螺旋CT低剂量扫描对小儿肘关节外伤的诊断价值[J].中国CT和MRI杂志,2010,8(3)：71-73
1.汪芳润,周晓东,周世铮,等.眼球径线CT测定与屈光的关系.中华眼科杂志,1994,30：39
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