摘要
目的:探讨128层双源CT低剂量大螺距扫描在双侧双向Glenn术后形态学评估中的临床应用价值。方法 :收集双侧双向Glenn术后患儿20例,均行低剂量大螺距扫描和DSA检査。大螺距扫描管电压为80 k V,管电流根据患儿体质量调节,螺距3.4。由2名医师采用5分法对图像质量进行主观评价。测量升主动脉根部、胸背部肌肉、双侧上腔静脉及肺动脉的CT值和噪声。记录剂量长度乘积以计算有效辐射剂量(effective dose,ED)。采用Kappa检验比较2名医师对图像质量主观评分的一致性。观察患儿术后形态学改变情况,并以DSA结果作为标准,评价CT的准确性。结果:所有患儿均成功完成低剂量大螺距扫描,图像均未出现运动伪影。升主动脉根部、双侧上腔静脉及肺动脉的CT值均超过250 HU,图像强化良好。图像质量主观评价平均得分(4.15±0.67)分,2名医师的一致性好(K=0.65,P<0.05)。CT发现上腔静脉扩张7处,肺动脉狭窄4处,体-肺循环侧支血管19支,以DSA结果作为标准,CT诊断准确率均为100%。患儿平均CTDIvol为(0.59±0.15)m Gy,平均DLP为(14.6±6.0)m Gy·cm,平均ED为(0.33±0.11)m Sv。结论:128层双源CT低剂量大螺距扫描在双侧双向Glenn术后形态学评估中可获取满足诊断的图像,且患儿无需屏气,具有较好的应用价值。
Objective：To explore the clinical value of low-dose prospectively ECG-gated high pitch spiral dual-source CT angiography（low-dose HP scanning） in patients with bilateral bidirectional Glenn shunt（b BDG）. Methods：Twenty patients with b BDG were prospectively enrolled. Low-dose HP scanning and DSA were performed within one week. The scanning parameters were 80 k V tube voltage and weight adapted setting for tube current. Two cardiac radiologists interpreted the image quality of great vessels using a 5-grade scoring system. The CT attenuation and the noise in the ascending aorta,chest muscles,bilateral superior vena cava（SVC） and pulmonary artery（PA） were measured. The dose length product was recorded to calculate the effective dose（ED）. Interobserver agreement on grades of subjective image quality was assessed by kappa statistics. Based on the findings of DSA,the accuracy of low-dose HP scanning was calculated. Results：The low-dose HP scanning and DSA were carried out in all the patients. There was no motion artifact due to the breath. The attenuation of the ascending aorta,bilateral SVC and PA was more than 250 HU. Overall interobserver agreement on subjective image quality was good（K=0.65,P〈0.05）.The average subjective image quality score was（4.15±0.67）. The morphological evaluation of HP scanning was quite consistent with that of DSA. The mean ED was（0.33±0.11）m Sv. Conclusion：Low-dose HP scanning is a convenient and noninvasive post-operative method of assessment for patients with b BDG,and there is a great clinic prospective with regard to the postoperative evaluation of patients with b BDG.
出处
《中国中西医结合影像学杂志》
2016年第3期252-255,259,共5页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
国家自然科学基金项目(81371547)
泰山学者工程专项经费资助
山东省自然科学基金项目(ZR2012HM006)
