目的 評(píng)估低劑量多排螺旋CT尿路造影技術(shù)(CTU)在評(píng)價(jià)兒童腎盂輸尿管交界部狹窄時(shí)降低兒童掃描劑量的程度以及其對(duì)CT圖像質(zhì)量的影響。
方法 掃描千伏恒定時(shí)(120kV),前瞻性按照檢查序號(hào)半隨機(jī)將30例腎盂輸尿管交界部狹窄患者按照受檢時(shí)不同掃描毫安(mA)數(shù)分成3組(115mA組、100mA組和75mA組)。分別統(tǒng)計(jì)靜脈期增強(qiáng)掃描時(shí)CT劑量權(quán)重指數(shù)(CTDIw)和劑量長(zhǎng)度乘積(DLP)。圖像質(zhì)量分為優(yōu)、良、差三級(jí)進(jìn)行評(píng)判并記錄評(píng)價(jià)結(jié)果。數(shù)據(jù)資料采用成組方差分析和秩和檢驗(yàn)進(jìn)行統(tǒng)計(jì)分析。
結(jié)果 115mA組、100mA組及75mA組的CTDIw分別為(7.63±0.83) mGy、(6.29±0.51) mGy和(4.72±0.18) mGy,3組間比較差異有統(tǒng)計(jì)學(xué)意義(F=36.445,P=0.000);75mA組的CTDIw僅為115mA組的61.8% (P<0.001)。該3組的DLP 分別為(173.89±29.88) mGy?cm、(145.96±26.21) mGy?cm和(102.78±12.72) mGy?cm,3組間比較差異有統(tǒng)計(jì)學(xué)意義(F=13.955,P=0.000);75mA組的DLP僅為115mA組的59.1% (P<0.001)。其他掃描條件和圖像后處理方式相同時(shí),管電流低至75mA時(shí)CTU圖像質(zhì)量并未減低,完全可滿(mǎn)足診斷要求。在圖像質(zhì)量評(píng)估上,3位醫(yī)師有很好的一致性(Kappa=0.736)。
結(jié)論 低劑量多排螺旋CTU在評(píng)價(jià)兒童腎盂輸尿管交界部狹窄時(shí)可有效降低CT劑量,減輕CTU檢查時(shí)多次CT掃描對(duì)兒童造成的輻射傷害,且并不犧牲圖像質(zhì)量。
引用本文: 張麗芝,曾涵江,黃子星,宋彬. 低劑量多排螺旋CT尿路造影技術(shù)在兒童腎盂輸尿管交界部狹窄的應(yīng)用評(píng)價(jià). 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(5): 565-568. doi: 復(fù)制
版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國(guó)普外基礎(chǔ)與臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編
1. | Prokop M. Radiation dose in computed tomography. Risks and challenges[J]. Radiology, 2008, 48(3):229-242. |
2. | Catalano C, Francone M, Ascarelli A, et al. Optimizing radiation dose and image quality[J]. Eur Radiol, 2007, 17 Suppl 6:F26-F32. |
3. | Morán LM, Rodríguez R, Calzado A, et al. Image quality and dose evaluation in spiral chest CT examinations of patients with lung carcinoma[J]. Br J Radiol, 2004, 77(922):839-846. |
4. | Mayo JR, Aldrich J, Muller NL, et al. Radiation exposure at chest CT:a statement of the Fleischner Society[J]. Radiology, 2003, 228(1):15-21. |
5. | Tack D, Widelec J, De Maertelaer V, et al. Comparison between low-dose and standard-dose multidetector CT in patients with suspected chronic sinusitis[J]. AJR Am J Roentgenol, 2003, 181(4):939-944. |
6. | Hagtvedt T, Aaløkken TM, Nøtthellen J, et al. A new low-dose CT examination compared with standard-dose CT in the diagnosis of acute sinusitis[J]. Eur Radiol, 2003, 13(5):976-980. |
7. | Dinkel HP, Sonnenschein M, Hoppe H, et al. Low-dose multisliceCT of the thorax in follow-up of malignant lymphoma and extrap-ulmonary primary tumors[J]. Eur Radiol, 2003, 13(6):1241-1249. |
8. | Tack D, De Maertelaer V, Gevenois PA. Dose reduction in multid-etector CT using attenuation-based online tube current modulation[J]. AJR Am J Roentgenol, 2003, 181(2):331-334. |
9. | Kalender WA, Wolf H, Suess C, et al. Dose reduction in CT by on-line tube current control: principles and validation on phantoms and cadavers[J]. Eur Radiol, 1999, 9(2):323-328. |
10. | Gies M, Kalender WA, Wolf H, et al. Dose reduction in CT by anatomically adapted tube current modulation. I. Simulation studies[J]. Med Phys, 1999, 26(11):2235-2247. |
11. | Golding SJ, Shrimpton PC. Radiation dose in CT:are we meetingthe challenge?[J]. Br J Radiol, 2002, 75(889):1-4. |
- 1. Prokop M. Radiation dose in computed tomography. Risks and challenges[J]. Radiology, 2008, 48(3):229-242.
- 2. Catalano C, Francone M, Ascarelli A, et al. Optimizing radiation dose and image quality[J]. Eur Radiol, 2007, 17 Suppl 6:F26-F32.
- 3. Morán LM, Rodríguez R, Calzado A, et al. Image quality and dose evaluation in spiral chest CT examinations of patients with lung carcinoma[J]. Br J Radiol, 2004, 77(922):839-846.
- 4. Mayo JR, Aldrich J, Muller NL, et al. Radiation exposure at chest CT:a statement of the Fleischner Society[J]. Radiology, 2003, 228(1):15-21.
- 5. Tack D, Widelec J, De Maertelaer V, et al. Comparison between low-dose and standard-dose multidetector CT in patients with suspected chronic sinusitis[J]. AJR Am J Roentgenol, 2003, 181(4):939-944.
- 6. Hagtvedt T, Aaløkken TM, Nøtthellen J, et al. A new low-dose CT examination compared with standard-dose CT in the diagnosis of acute sinusitis[J]. Eur Radiol, 2003, 13(5):976-980.
- 7. Dinkel HP, Sonnenschein M, Hoppe H, et al. Low-dose multisliceCT of the thorax in follow-up of malignant lymphoma and extrap-ulmonary primary tumors[J]. Eur Radiol, 2003, 13(6):1241-1249.
- 8. Tack D, De Maertelaer V, Gevenois PA. Dose reduction in multid-etector CT using attenuation-based online tube current modulation[J]. AJR Am J Roentgenol, 2003, 181(2):331-334.
- 9. Kalender WA, Wolf H, Suess C, et al. Dose reduction in CT by on-line tube current control: principles and validation on phantoms and cadavers[J]. Eur Radiol, 1999, 9(2):323-328.
- 10. Gies M, Kalender WA, Wolf H, et al. Dose reduction in CT by anatomically adapted tube current modulation. I. Simulation studies[J]. Med Phys, 1999, 26(11):2235-2247.
- 11. Golding SJ, Shrimpton PC. Radiation dose in CT:are we meetingthe challenge?[J]. Br J Radiol, 2002, 75(889):1-4.