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3.06mSv,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=2.43
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).
作者
王镇章
曹国全
傅萍萍
郭献忠
杨运俊
满意
陈伟建
Wang Zhenzhang;Cao Guoquan;Fu Pingping;Guo Xianzhong;Yang Yunjun;Man Yi;Chen Weijian(Department of Radiology,First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)
出处
《中华放射医学与防护杂志》
CAS
CSCD
北大核心
2019年第2期155-160,共6页
Chinese Journal of Radiological Medicine and Protection
