摘要
目的探讨双源CT前瞻性心电触发大螺距扫描（简称大螺距扫描）在小儿先天性心脏病（简称先心病）中的临床应用价值。方法搜集行大螺距扫描的36例先心病患儿的影像资料，记录其剂量长度乘积（DLP），计算出有效辐射剂量（ED）。由2名放射科医师在双盲的情况下独立诊断并用5分法对图像质量进行评估。2名医师对图像质量评估符合程度的评价采用Kappa检验。以手术或DSA结果为金标准，计算大螺距扫描诊断先心病的准确度、敏感度和特异度。结果36例患儿大螺距扫描的DLP为（2．4—9．2）mGy·cm，平均（5．1±1．6）mGy·cm，ED为（0．078～0．179）mSv，平均（0．125±0．027）mSv。图像质量均符合诊断要求；2名放射科医师的图像质量评价一致性好（K=0．774，P〈0．05）。大螺距扫描诊断先心病的准确度、敏感度、特异度分别为98．9％、94．2％、99．8％。结论双源CT大螺距扫描技术降低了受检患儿的辐射剂量，图像仍满足诊断要求，为小儿先心病的诊断提供了一种新的可供选择的方法。
Objective To explore the clinical value of prospective electrocardiography-triggering high-pitch spiral acquisition by dual-source CT （HP mode ） in children with congenital heart diseases （CHD）. Methods Thirty-six patients （mean age：0. 67 years, range： 1 month to 2 years and 6 months; 25 males;mean weight：7.7 kg）underwent prospective ECG-triggering high-pitch spiral acquisition. The dose length product （ DLP ） was recorded to calculate effective dose （ ED ）. Two experienced radiologists made diagnosis and assessed the overall image quality by a five-point scale independently. The consistency of their judgment was determined by Kappa statistics. Surgeries were performed in 29 patients, and conventional cardiac angiography （CCA） was performed in 7 patients. The accuracy, sensitivity and specificity of HP mode were calculated based on the surgical or CCA findings. Results The DLP was （5. 12 ± 1.64） mGy · cm with a range of 2.4 mGy ·cm to 9. 2 mGy ·cm and ED was（0. 125 ±0. 027） mSv ranging from 0. 078 mSv to 0. 179 mSv. The average subjective image quality score was 4. 2 ± 0. 7. All images were diagnosable. Two radiologists made good agreement （ K = 0. 774, P 〈 0. 05 ）. The accuracy, sensitivity and specificity of HP mode were 98.9%, 94. 2% and 99. 8% , respectively. Conclusion Low radiation dose with the accurate diagnosis of anomalies makes HP mode a new choice for children with CHD.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第10期925-928,共4页
Chinese Journal of Radiology
