| 边传振,张见,王颖,等.DoseRight技术条件下颈椎前凸体位在学龄前儿童颈部CT检查的应用[J].中华放射医学与防护杂志,2020,40(3):241-246.Bian Chuanzhen,Zhang Jian,Wang Ying,et al.Application of cervical anterior flexion in CT examination of neck for preschool children with Dose Right technique[J].Chin J Radiol Med Prot,2020,40(3):241-246 |
| DoseRight技术条件下颈椎前凸体位在学龄前儿童颈部CT检查的应用 |
| Application of cervical anterior flexion in CT examination of neck for preschool children with Dose Right technique |
| 投稿时间：2019-08-31 |
| DOI：10.3760/cma.j.issn.0254-5098.2020.03.015 |
| 中文关键词: 颈部 学龄前儿童 辐射剂量 体型特异性剂量估算值 |
| 英文关键词:Neck Preschool children Radiation dose Size-specific dose estimate |
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| 摘要点击次数: 3045 |
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| 中文摘要: |
| 目的 分析在DoseRight技术条件下采用自制海绵垫使患儿颈椎保持前凸位进行颈部CT检查对其辐射剂量及图像质量的影响。方法 前瞻性的连续采集2018年1月至2018年7月，在南京医科大学附属儿童医院行颈部CT检查的1~5岁患儿125例，将患儿采用随机数表法分为对照组和试验组，对照组61例，试验组64例，对照组患儿仰卧于扫描床上头部固定于CT头颅支架内，实验组患儿仰卧于扫描床上，颈部用自制海绵垫垫高，使患儿头颅后仰且肩部下垂，采用荷兰飞利浦Brilliance128iCT进行数据采集，从工作站剂量报表获得患儿的容积CT剂量指数（CTDIVOL）并计算患儿的体型特异性剂量估算值（SSDEED）和水当量直径剂量估算值（SSDEWD），测量患儿第3颈椎中部层面椎旁肌肉区和甲状软骨层面甲状腺区域的噪声值及信噪比，对图像质量进行客观评价，依据颈部各结构的显示情况，采用5分制评分对图像质量进行主观评价。结果 试验组患儿椎旁肌肉区和甲状腺区噪声值均低于对照组（t=-6.93、-7.41，P<0.05）而信噪比均高于对照组（t=5.74、6.14，P<0.05）；两组患儿颈部图像质量主观评价，实验组（4.32±0.70）优于对照组（3.70±0.66），差异有统计学意义（Z=-4.27，P<0.05）；实验组患儿颌咽角度数和椎体显示数目均高于对照组（t=4.94、5.09，P<0.05）；对照组患儿的CTDIVOL、SSDEWD和SSDEED分别较实验组高22.1%、26.0%和27.1%（t=6.17、5.11、4.35，P<0.01）。结论 在DoseRight技术条件下采用自制海绵垫使患儿颈椎保持前凸位进行颈部CT检查能够降低辐射剂量同时提高图像质量；采用SSDEWD来表示患儿的辐射剂量更加准确。 |
| 英文摘要: |
| Objective To analyze the influence on radiation dose and image quality of children neck CT with anterior flexion of cervical spine using self-made sponge pad with DoseRight technique. Methods A total of 125 children aged 1-5 years who underwent neck CT examination were consecutively collected prospectively. The patients were divided into control group and test group with computer random number method. The control group was supine on the scanning bed and fixed in the CT skull stent. The test group was supine on the scanning bed with a self-made sponge cushion under the neck to extend the head and droop the shoulder. The data was acquired with Philips Brilliance iCT and CTDIVOL was obtained from the dose report. SSDEED and SSDEWD were calculated seperately.The image quality by measuring the noise value and signal-to-noise ratio of the paravertebral muscle area at the middle level of the third cervical vertebra and thyroid area. Subjective evaluation of image quality by 5-point scoring systemwas performed. Results The noise values of paravertebral muscles and thyroid regions in the test group were lower than those in the control group(t=-6.93,-7.41,P<0.05),and the signal-to-noise ratios were higher than those in the control group (t=5.74,6.14,P<0.05). The subjective score of the test group (4.32±0.70) was better than that of the control group (3.70±0.66), and the difference was statistically significant (Z=-4.27,P<0.05). The jaw-pharynx angle and the number of vertebra displayed of the test group were higher than those of the control group (t=4.94,5.09,P<0.05).CTDIVOL,SSDEWD and SSDEED in the control group were 22.1%, 26.0% and 27.1% higher than those in the test group (t=6.17,5.11,4.35, P<0.01). Conclusions SSDEWD is more accurate to indicate the CT radiation dose of children. The self-made sponge pad keeping the cervical spine in anterior flexion can reduce radiation dose and improve image quality. |
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