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基于下颈部横径的低辐射剂量颈部增强MDCT的可行性研究
引用本文:周静然,查云飞,杨峰.基于下颈部横径的低辐射剂量颈部增强MDCT的可行性研究[J].CT理论与应用研究,2017,26(3):349-356.
作者姓名:周静然  查云飞  杨峰
作者单位:1. 武汉大学人民医院放射科, 武汉 430063;
摘    要:目的:探讨基于下颈部横径的低辐射剂量颈部增强MDCT的可行性。方法:对126例临床拟诊为颈部病变的患者行颈部CT检查,其中42例为常规剂量组,84例为低剂量组。低剂量组再根据患者下颈部横径的大小分为3个亚组:A组大横径组,横径≥40cm(21例);B组中等横径组,35cm≤横径<40cm(35例);C组小横径组,横径<35cm(28例)。常规剂量组管电压/管电流采用120kV/350mA,低剂量A、B、C3组分别采用120kV/300mA、100kV/300mA和80kV/300mA。对常规剂量组与低价量组扫描图像进行主观及客观评价,记录A、B、C3组不同扫描方案的剂量长度乘积(DLP)和CT容积剂量指数(CTDIvol),并计算有效辐射剂量(ED)。比较各组辐射剂量及图像质量的差异。结果:常规剂量组与低剂量A、B、C三组有效吸收剂量ED分别为(1.34±0.13)mSv、(1.17±0.10)mSv、(0.74±0.08)mSv和(0.34±0.04)mSv,差异有统计学意义(F=606.13,P<0.01),各低剂量组的有效辐射剂量均低于常规组。组间两两比较ED差异均有统计学差异(P值均<0.01)。Kappa一致性检验显示两名医师对颈部图像质量的评分一致性较高(3组Kappa值均>0.70),常规剂量组与低剂量A、B、C3组比较图像质量评分均无统计学差异(Z=-0.258,P>0.05),各组的图像对比噪声比无统计学差异(F=0.750,P>0.05)。结论:根据患者下颈部横径的大小采用不同管电压行颈部增强CT扫描可以明显降低患者的辐射剂量,而不影响图像的诊断质量,该扫描方案显示颈部结构可行。 

关 键 词:颈部疾病    辐射剂量    体层摄影术    X线计算机
收稿时间:2016-12-12

Feasiblity of Low-dose Neck Enhancement MDCT Based on Lower Neck Transverse Diameter
ZHOU Jing-ran,ZHA Yun-fei,YANG Feng.Feasiblity of Low-dose Neck Enhancement MDCT Based on Lower Neck Transverse Diameter[J].Computerized Tomography Theory and Applications,2017,26(3):349-356.
Authors:ZHOU Jing-ran  ZHA Yun-fei  YANG Feng
Institution:1. Department of Radiology, Renmin Hospital of Wuhan University, Wuhan 430036, China;2. Department of Radiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, China
Abstract:Objective:To explore the feasibility of low-dose neck enhancement MDCT based on the lower neck transverse diameter.Methods:One hundred and twenty-six consecutive patients with suspected of cervical disease undergoing 64-MDCT were prospectively selected and divided into 2 groups at random:conventional group and low dose group.According to the lower neck transverse diameter the low dose group were divided into 3 subgroups at large diameter (group A,diameter ≥ 40 cm,n =21) or medium diameter (group B,35 cm < diameter <40 cm,n=35) or small diameter (group C,diameter< 35 cm,n =28).The tube voltage/tube current of conventional group was 120kV/350mA.And that of low dose were 120kV/300mA,100kV/300mA,80 kV/300 mA in A,B,C group,respectively.The dose-length product (DLP) and CT dose index volume (CTDIvol) of each group were recorded,and then the effective radiation dose (ED) were calculated.The image quality and radiation dose were evaluated and compared among 4 groups.Results:The radiation dose of 4 groups were respectively 1.34 mSv ± 0.13 mSv,1.17 mSv ± 0.10 mSv,0.74 mSv ± 0.08 mSv,0.34 mSv ± 0.04mSv,the difference was statistically significant (F=606.13,P < 0.01),the effective radiation dose of A,B,C group was significantly lower than that in the conventional group.There was significant difference between arbitrary two of the four groups,respective (all P< 0.01).Kappa conformance test showed that the image quality scores determined by two physicians were highly consistent with each other (all Kappa value > 0.70).No significant difference in image quality (Z =-0.258,P > 0.05) and contrast to noise of 4 groups (F =0.750,P > 0.05).Conclusion:Based on patient's lower neck transverse diameter,neck enhancement MDCT with different suitable tube voltage can effectively reduce the radiation dose,while high quality image of neck structure can still be ensured.
Keywords:cervical disease  radiation dose  tomography  X-ray computer
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