摘要
目的探讨640层螺旋CTU分泌期低剂量容积扫描方案（80k V＋自动毫安＋AIDR）在诊断肾盏憩室中的应用价值,并分析肾盏憩室的影像学特点。方法搜集15例经手术或静脉肾盂造影证实为肾盏憩室患者,所有病例均行640层螺旋CTU多期扫描,且分泌期采用低剂量容积扫描方案。由三位不同年资医师（A、B、C）采用双盲法分别对CTU分泌期扫描前后图像进行后处理并分析、诊断。记录所有患者各期扫描容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）,并计算出有效辐射剂量（ED）。结果 A医师CTU分泌期图像前后诊断符合率分别为13.3%（2/15）、86.7%（13/15）,前后诊断符合率有显著统计学意义（χ^2=16.13,P〈0.05）;B医师CTU分泌期图像前后诊断符合率分别为6.7%（1/15）、73.3%（11/15）,前后诊断符合率有显著统计学意义（χ^2=13.89,P〈0.05）;C医师CTU分泌期图像前后诊断符合率分别为20%（3/15）、66.7%（10/15）,前后诊断符合率有显著统计学意义（χ^2=6.65,P〈0.05）。在低剂量容积扫描方案下,分泌期单期平均ED较皮质期、髓质期减少了43.0%,CTDIvol则减少了42.9%,分泌期ED仅占总ED的15.89%。结论 640层螺旋CTU分泌期低剂量容积扫描不仅能明显提高肾盏憩室的诊断准确率,而且能明显降低单期ED,其临床意义重大,值得临床应用推广。
Objective To discuss the diagnostic value of 640-slice CT urography low lose（ tube voltage 80 kV ＋ automatic m As ＋ adaptive iterative dose reduction） excretory phase in calyceal diverticulum,and investigate the image characteristics. Methods 15 cases of calyceal diverticulum confirmed by surgery or IVP were included. All cases underwent 640-slice spiral CTU multi-phase scan,and the low-dose volume scan protocol was used during the secretory phase. The images of the CTU secretory phase before and after the scan were post-processed and analyzed and diagnosed by three different senior physicians（ A,B,C）. The scan volume CT dose index（ CTDI vol）,dose length product（ DLP） of all patients were recorded,and the effective radiation dose（ ED） was calculated. Results The coincidence rate of A doctor＇s CTU secretory period was 13. 3%（ 2/15） and 86. 7%（ 13/15）,respectively. The coincidence rate was statistically significant（ χ^2=16. 13,P〈0. 05）; The coincidence rate of pre-and post-diagnosis of CTU secretory phase was 6. 7%（ 1/15） and 73. 3%（ 11/15）,respectively. The coincidence rate was statistically significant（ χ^2= 13. 89,P〈0. 05）; C physician secretory period The coincidence rates of pre-and post-diagnosis were 20%（ 3/15） and 66. 7%（ 10/15）,respectively,and the coincidence rate was statistically significant（ χ^2= 6. 65,P〈0. 05）. Under the low dose volume scanning protocol,the singlephase average effective radiation dose ED decreased by 43. 0% compared with the cortical and medullary phases,and the CTDIvol decreased by 42. 9%. The effective radiation dose during the secretory phase only accounted for 15. 89% of the total effective radiation dose. Conclusion The low-dose volume scan of the 640-slice spiral CTU can not only improve the diagnostic accuracy of the renal diverticulum,but also significantly reduce the single-stage effective radiation dose. The clinical significance is significant and worthy of clinical application.
作者
梁占东
刘燕霞
刘彦芳
朱月香
崔书君
LIANG Zhandong;LIU Yanxia;LIU Yanfang(Department of Medical Image,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei Province 075000,P.R.Chin)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第7期1212-1215,共4页
Journal of Clinical Radiology
