摘要
目的探讨基于体重指数(BMI)的降低管电流低辐射剂量CTU显示上尿路结构的可行性。方法 110例临床拟诊泌尿系疾病的患者行CTU检查,其中50例行标准剂量扫描(120 kV、250 mA),60例根据患者的BMI大小分别采用120 mA、80 mA、50 mA行低剂量扫描。2名医师对两种方法显示肾内集合系统、近段、中段、远段输尿管的图像质量进行评分,记录不同扫描方法的剂量长度乘积(DLP)和CT容积剂量指数(CTDIvol),比较两种方法对肾脏集合系统及输尿管各段显示的差别。结果标准剂量组与低剂量组BMI差异无统计学意义(t=0.56,P>0.05)。标准剂量组与低剂量组的DLP分别为(424.51±40.28)和(148.43±33.88)mGy·cm,CTDIvol分别为(10.39±0.61)和(3.71±0.87)mGy,两组辐射剂量差异有统计学意义(t=38.32,P<0.01)。低剂量1组、低剂量2组与标准剂量组比较,3个组间DLP和CTDIvol值差异均有统计学意义(F=1171.19,F=2439.17,P<0.01),其中3个组之间两两比较DLP和CTDIvol值差异均有统计学意义(P<0.01)。Kappa一致性检验示2名医师对肾内集合系统、近段、中段、远段输尿管图像质量评分的一致性较高(Kappa值均大于0.75)。标准剂量组CTU与低剂量组CTU对上尿路各节段结构的显示效果评分无显著性差异(P>0.05)。结论根据患者的BMI采用不同管电流的CTU可以降低患者辐射剂量,该扫描方案显示上尿路结构是可行的。
Objective To explore the feasibility of using multi-detector CT urography （MDCTU） with body mass index （ BMI）-based low-dose scanning protocol to display upper urinary tract structures. Methods A total of 110 patients with suspected urologic diseases were enrolled in this study. The patients were divided into control group （ n = 50） and study group （n = 60）. MDCTU scanning with standard dose （120 kV, 250mA） was performed in the patients of the control group, while BMI-based low-dose （120, 80 or 50 mA） scanning protocol was employed in the patients of the study group. The dose length product （DLP） and CT dose index （CTDIvol） were recorded and the image quality of upper urinary tract, including renal collecting system and ureter, was graded by two radiologists. The results were compared between the two groups. Results No significant difference in BMI existed between the two groups （t = 0. 56, P 〉 0.05）. The DLP of the control group and the study group was （424.51 ± 40.28） mGy· cm and （148.43±33.88） mGy · cm respectively, while the average CT volume dose index （CTDIvol） was （ 10.39 ±0.61 ） mGy and （3.71±0.87） mGy respectively. Statistical- ly significant difference in radiation dose existed between the two groups （ t = 38.32, P 〈 O. O1 ）. Statistically significant differences in DLP and CTDIvol existed between each other among the following groups ： the study subgroup （ 120 mA）, the study subgroup （80 mA） and the control group （P 〈 O. O1 ）. Kappa conformance test showed that the image quality scores determined by two physicians were highly consistent with each other. No significant difference in image quality of upper uri- nary tract existed between the two groups （ P 〉 O. 05 ） . Conclusion Based on patient＇ s BMI, CTU with different suitable tube current can effectively reduce the radiation dose, while high quality image of upper urinary tract can still be ensured .
出处
《临床放射学杂志》
CSCD
北大核心
2014年第9期1425-1429,共5页
Journal of Clinical Radiology
