| 王镇章,曹国全,傅萍萍,等.320排CT单心动周期动态容积扫描对高心率患者支气管动脉CT成像辐射剂量及图像质量的影响[J].中华放射医学与防护杂志,2019,39(2):155-160.Wang Zhenzhang,Cao Guoquan,Fu Pingping,et al.Influence on radiation dose and image quality of bronchial artery CTA for high heart rate patients with single-cardiac dynamic volumetric scanning in 320-row CT[J].Chin J Radiol Med Prot,2019,39(2):155-160 |
| 320排CT单心动周期动态容积扫描对高心率患者支气管动脉CT成像辐射剂量及图像质量的影响 |
| Influence on radiation dose and image quality of bronchial artery CTA for high heart rate patients with single-cardiac dynamic volumetric scanning in 320-row CT |
| 投稿时间：2018-10-26 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.02.014 |
| 中文关键词: 体层摄影术,X射线计算机 支气管动脉CT成像 图像质量 辐射剂量 |
| 英文关键词:Tomography, X-ray computer Bronchial artery CT angiography Image Quality Radiation dose |
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| 中文摘要: |
| 目的 探讨高心率咯血患者，采用自由呼吸状态下320排CT单心动周期动态容积扫描，对支气管动脉CT成像（CTA）图像质量及辐射剂量的影响。方法 连续收集温州医科大学附属第一医院2016年10月至2017年5月151例心率≥65次/min咯血患者进行前瞻性研究，采用320排前瞻性心电门控动态容积CT进行自由呼吸下支气管动脉成像，按例数不等的完全随机区段分组法分成A、B两组，A组81例，B组70例。A组采用320排CT默认的多心动周期扫描生成多扇区图像A1，经2次重建获得单扇区图像A2；B组采用单心动周期扫描生成单扇区图像B。比较两种扫描方式的辐射剂量指标，比较B组与A1、A2组的图像质量客观指标[血管CT值、图像噪声（SD）、信噪比（SNR）、对比噪声比（CNR）]与图像质量主观评分，并对照数字减影血管造影（DSA）用受试者工作特征（ROC）曲线评价其对体循环-肺循环瘘检出的准确性。计量资料采用独立样本t检验，等级资料采用独立样本非参数检验。结果 B组与A组的辐射有效剂量的中位数分别为1.42和3.06 mSv，B组显著低于A组，差异有统计学意义（Z=-8.724，P<0.05）；B组与A2组的图像质量客观指标、图像质量主观评分的差异均无统计学意义（P>0.05），B组图像质量主观评分中位数为4，明显高于A1组的2，差异有统计学意义（Z=-10.584，P<0.05）；B组和A1组图像SD值分别为（25.7±0.35）和（13.9±0.36），两组比较差异有统计学意义（t=-0.983，P<0.05），B组和A1组SNR值分别为（38.5±6.9）和（48.4±10.6），B组明显低于A1组，差异有统计学意义（t=7.898，P<0.05），B组和A1组的CNR值分别为（31.61±8.80）和（45.36±13.01），B组亦明显低于A1组，差异有统计学意义（t=7.695，P<0.05）；两组检查的主动脉、肺动脉平均CT值差异均无统计学意义（P>0.05）。B组和A2组对体循环-肺循环瘘检出的准确性中等偏高，ROC曲线下面积（AUC）分别为0.891和0.864（Z=7.210、7.430，P<0.05），A1组的准确性较差，ROC曲线下面积为0.626（Z=2.434，P<0.05）；B组和A1、A2组灵敏度分别为80.0%、28.6%和76.2%。结论 320排单心动周期动态容积CT在降低支气管动脉CTA检查辐射剂量的同时，可以有效提高图像质量及对体循环-肺循环瘘CT检出的准确性。 |
| 英文摘要: |
| Objective To assess the influence on radiation dose and image quality of bronchial artery CT angiography for hemoptysis patients with high heart rate and free respiratory with single-cardiac dynamic volumetric scanning using 320-row CT. Methods During October 2016 and May 2017, totally 151 hemoptysis patients with heart rate ≥ 65 bmp and free-breathing were scanned for bronchial artery imaging with prospective ECG-gating 320-detector row dynamic volume CT. The patients were randomly divided into two groups, group A(81 cases) and group B(70 cases). Default multi-cardiac cycle scanning style was used for group A to generate multi-sector images A1 which were reconstructed corresponding single-sector images A2. Single-cardiac periodic scanning was used to get single-sector images for group B. The effective doses (E) of two scanning types, the quantitative parameters of image quality[vascular CT value, image noise (SD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)] and subjective scoring of group B and A1, A2 were compared. The detection accuracy of the systemic artery-pulmonary circulation shunts was evaluated by ROC curve against digital subtraction angiography(DSA). The measurement data was analyzed by independent sample t test while the grade data was tested by independent sample nonparametric test. Results The median value of radiation dose in group B was significantly lower than that of group A (1.42 mSv vs. 3.06 mSv, Z=-8.724,P<0.05). There were no statistically significant differences in quantitative parameters and subjective scoring points of image quality between group B and group A2 (P>0.05). The median subjective scoring points of group B was 4, which was better than that of group A1 (Z=-10.584, P<0.05). The differences of SD, SNR, CNR between group B and group A1 were statistically significant(t=-0.983, 7.898, 7.695, P<0.05), and group B had higher SD, SNR and CNR. There was no significant difference in the mean CT values of the aorta and pulmonary artery between the two groups (P>0.05). The detection accuracy of the systemic artery-pulmonary circulation shunts was moderately high in group B and group A2. The area under the ROC curve (AUC) was 0.891 and 0.864, respectively (Z=7.210, 7.430, P<0.05). The accuracy of group A1 was poor. The area under the ROC curve was 0.626 (Z=2.434, P<0.05). The sensitivity of group B and group A2 were 80% and 76.2%, respectively (P<0.05), and 28.6% of group A1 (P<0.05). Conclusions The 320-row single-cardiac periodic dynamic volume CT can effectively improve the image quality and the detection accuracy of the systemic-pulmonary circulation on CT, and reduce the radiation dose of the bronchial artery CT angiography. |
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