| 边传振,张见,王颖,刘杰,杨明.双上肢垫高体位在儿童气道异物CT检查的应用[J].中华放射医学与防护杂志,2019,39(10):795-800 |
| 双上肢垫高体位在儿童气道异物CT检查的应用 |
| Application of upper limbs-raised position in CT examination of airway foreign body in children |
| 投稿时间：2019-01-21 |
| DOI：10.3760/cma.j.issn.0254-5098.2019.10.015 |
| 中文关键词: 气道异物 上肢 辐射剂量 |
| 英文关键词:Airway foreign bodies Upper limbs Radiation dose |
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| 中文摘要: |
| 目的 通过改变CT检查气道异物的儿童双上肢的摆放体位，来明确双上肢和颈胸椎的相对位置关系对图像质量及辐射剂量的影响。方法 前瞻性地分析行气道CT检查的1~48月患儿103例，CT检查时根据双上肢摆放位置按随机数表法将患儿分为A、B、C 3组，A组34例，B组36例，C组33例。A组患儿双上肢上举置于颈椎两侧，B组患儿双上肢置于胸椎两侧，C组患儿双上肢用海绵垫抬高约45°置于胸部两侧。采用荷兰飞利浦128iCT进行数据采集，记录3组患儿的容积CT剂量指数（CTDIvol）及剂量长度乘积（DLP）并进行对比分析，然后对所得图像质量进行主观及客观评价。结果 颈部图像质量主观评分，B组（4.33±0.72）和C组（4.19±0.63）均优于A组（3.71±0.66），差异均有统计学意义（Z=-3.19、-2.61，P<0.05）；胸部图像质量主观评分，A组（4.21±0.47）优于B组（3.71±0.39）和C组（3.92±0.42），C组优于B组，差异均有统计学意义（Z=-1.71、-2.08，P<0.05）；DLP间的差异，B组（57.7±6.8）mGy·cm高于A组（51.6±7.6）mGy·cm和C组（51.3±6.3）mGy·cm，差异有统计学意义（P<0.05），A组和C组间的差异无统计学意义（P>0.05）。结论 行儿童气道异物CT检查时，将双上肢抬高45°置于胸部两侧，会改善气道CT检查的图像质量，同时降低辐射剂量。 |
| 英文摘要: |
| Objective To confirm the effect of the relative position between upper limbs and cervicothoracic vertebrae on image quality and radiation dose while performing airway CT examination of children with airway foreign bodies. Methods One hundred and three children, aged from 1 to 48 months were enrolled prospectively and divided into 3 groups according to the position of upper limbs.In group A, the upper limbs were raised beside the cervical vertebra, in group B, the upper limbs were placed beside the thoracic vertebra, and in group C, the upper limbs were raised about 45 degrees with sponge pads and placed beside the chest. Data were acquired by Philips 128iCT, and CT dose index (CTDIvol) and dose-length product (DLP) were recorded and compared among three groups. The image qualities were evaluated subjectively and objectively. Results Subjective score of cervical image quality in group B (4.33±0.72) and group C (4.19±0.63) were higher than that in group A (3.71±0.66), and the difference was statistically significant (Z=-3.19、-2.61, P<0.05). Subjective score of chest image quality in group A (4.21±0.47) was higher than that in group B (3.71±0.39) and group C (3.92±0.42), and group C was higher than that in group B, the difference was statistically significant (Z=-1.71,-2.08, P<0.05). The difference of DLP in group B (57.7±6.8) mGy·cm was higher than that in group A (51.6±7.6) mGy·cm and group C (51.3±6.3) mGy·cm,the difference was statistically significant (P<0.05),and there was no significant difference between group A and group C (P>0.05). Conclusions Raising upper limbs 45 degrees and placing them beside the chest will improve the CT image quality of airway and reduce the radiation dose. |
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