[1]樊敏,邹萌,陈庭宇,等.双低扫描方案结合迭代重建CT血管成像在婴幼儿先天性心脏病诊断的应用[J].中国医学物理学杂志,2020,37(2):185-189.[doi:DOI:10.3969/j.issn.1005-202X.2020.02.010]
　FAN Min,ZOU Meng,CHEN Tingyu,et al.Application of low radiation dose and low contrast agent scanning protocol combined with iterative reconstruction CT angiography in the diagnosis of congenital heart diseases in infants[J].Chinese Journal of Medical Physics,2020,37(2):185-189.[doi:DOI:10.3969/j.issn.1005-202X.2020.02.010]
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双低扫描方案结合迭代重建CT血管成像在婴幼儿先天性心脏病诊断的应用()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第2期
页码:
185-189
栏目:
医学影像物理
出版日期:
2020-02-25

文章信息/Info

Title:
Application of low radiation dose and low contrast agent scanning protocol combined with iterative reconstruction CT angiography in the diagnosis of congenital heart diseases in infants
文章编号:
1005-202X（2020）02-0185-05
作者:
樊敏; 邹萌; 陈庭宇; 李娟; 程巍
四川大学华西医院放射科， 四川 成都 610041
Author(s):
FAN Min;  ZOU Meng;  CHEN Tingyu;  LI Juan;  CHENG Wei
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
关键词:
婴幼儿; 先天性心脏病; 体层摄影术; Ｘ线计算机; 对比剂; 迭代重建
Keywords:
Keywords: infant;  congenital heart disease;  computed tomography;  X-ray computer;  contrast agent;  iterative reconstruction
分类号:
R814.42；R725.4
DOI:
DOI:10.3969/j.issn.1005-202X.2020.02.010
文献标志码:
A
摘要:
【摘要】目的：探讨双源炫速CT-flash低剂量扫描技术及低对比剂注射方案结合迭代重建CT血管成像在婴幼儿先天性心脏病诊断中的价值。方法：收集拟诊断为先天性心脏病行心脏血管扫描的患者86例，随机分为实验组（44例）与对照组（42例），分别采用双低扫描方案与常规扫描方案，记录两组患者的对比剂用量，容积CT剂量指数和剂量长度乘积，计算有效辐射剂量（ED）；由两位经验丰富的放射医师独立诊断并采用4分法对图像质量进行评估，对结果一致性评价采用Kappa检验；测量两组图像的信噪比和对比度噪声比（CNR）；以数字减影血管造影或手术结果作为金标准，比较两种扫描方法的诊断价值。结果：实验组患儿的ED为（0.30±0.16） mSv，对照组患儿ED为（0.97±0.34） mSv，差异有统计学意义（P<0.01）；对比剂注射剂量分别为（10.01±1.87）和（16.04±3.17） mL，差异有统计学意义（P<0.05）；实验组图像质量评分（3.40±0.57）分，优于对照组（2.90±0.89）分，两组图像均符合诊断要求，差异有统计学意义（P<0.05）；两组图像CNR差异有统计学意义；实验组与对照组的诊断敏感度分别为97.4％和97.9％，特异度分别为98.7％和97.7％，诊断准确率分别为98.3%和97.8%，差异无统计学意义。结论：双低扫描方案结合迭代重建技术可大大降低婴幼儿患者的CT辐射剂量与对比剂注射剂量，图像质量优于常规扫描方案，且诊断准确率高，适合在临床扫描中推广运用。
Abstract:
Abstract: Objective To explore the diagnostic value of Somatom Definition Flash of low radiation dose and low contrast agent combined with iterative reconstruction CT angiography in congenital heart diseases (CHD) in infants. Methods Eighty-six patients with suspected CHD for angiography were randomly divided into experimental group (44 cases) and control group (42 cases) for low radiation dose and low contrast agent scanning protocol and conventional scanning protocol, separately. The contrast agent, volumetric CT dose index (CTDIvol) and dose-length product in two groups were recorded, and the effective radiation dose was calculated. The image quality was independently diagnosed by 2 experienced radiologists and assessed by 4 scores, and Kappa test was used for the consistency evaluation. The signal-to-noise ratios and contrast-to-noise ratios in two groups were measured. The diagnostic values of the two scanning protocols were compared with the surgical results or digital subtraction angiography as the gold standard. Results The effective radiation doses of infants in experimental group and control group were (0.30±0.16) mSv and (0.97±0.34) mSv, respectively, with statistical differences (P<0.01), and the injection of contrast agents were (10.01±1.87) mL and (16.04±3.17) mL, respectively, with statistical differences (P<0.05). Although the image quality score of experimental group was higher than that of control group, with statistical differences (3.40±0.57 vs 2.9±0.89, P<0.05), both the image quality of the two groups met the diagnostic requirements. There were significant differences in contrast-to-noise ratio between two groups. The diagnostic sensitivities of experimental group and control group were 97.4% and 97.9%; the specificities were 98.7% and 97.7%; and the diagnostic accuracies were 98.3% and 97.8%, respectively. Conclusion The low radiation dose and low contrast agent scanning protocol combined with iterative reconstruction technique which can greatly reduce CT radiation dose and contrast agent injection for infant patients, obtain image quality which is better than that obtained by conventional scanning protocol and achieve a higher diagnostic accuracy is suitable for clinical application.

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备注/Memo

备注/Memo:
【收稿日期】2019-09-21 【基金项目】国家自然科学基金（81571638） 【作者简介】樊敏，初级技师，研究方向：CT和MR技术，E-mail: cw569282997@163.com 【通信作者】程巍，研究方向：胸部CT和MR技术，E-mail: 420496843@qq.com
更新日期/Last Update: 2020-03-03