CAJ | 학술논문

目的探讨减轻和消除双上肢均不能上举患者胸腹部CT图像伪影的扫描技术,提高图像质量.方法选取2004年3月至2009年5月间行胸腹部CT检查的双上肢均不能上举患者61例.2007年6月前31例双上肢均不能上举患者按常规体位行CT扫描(常规组,双上肢自然放置于身体两侧),分析胸腹部CT图像伪影的表现和发生机理.2007年6月以后的30例患者采用改进后的技术行CT扫描(改进组,改变双上肢和胸椎的相对位置,使他们不在同一条直线上),同时选取30例双上肢均能上举患者(对照组)进行比较.由2名CT主管技师和1名影像诊断副主任医师在不知道扫描方法的情况下对3组患者图像伪影进行双盲法评价分级(分为严重、较重、中、轻和无5级),测量3组患者图像伪影区和非伪影区的肝脏CT值和图像噪声值,并计算出平均值.3组患者图像伪影分级评价结果比较采用χ~2检验,肝脏CT值和图像噪声差异比较采用单因素方差分析.结果常规组严重伪影11例、较重伪影15例、中度伪影5例;改进组中度伪影6例、轻度伪影15例、无伪影9例;对照组轻度伪影8例、无伪影22例,改进组的图像质量明显优于常规组(χ~2=95.32,P<0.01).无伪影区肝脏CT值和图像噪声值常规组分别为(54.5±3.0)HU和10.7±2.4,改进组为(52.0±3.5)HU和10.7±0.5,对照组为(53.7±3.1)HU和9.9±0.5.伪影区肝脏CT值和图像噪声值常规组分别为(41.7±8.4)HU和17.9±2.6,改进组的为(53.1±6.9)HU和11.0±0.7,对照组为(54.1±2.4)HU和9.9±0.5.常规组图像伪影区的肝脏CT值和图像噪声变化范围明显增大,噪声平均值也大幅增加,明显高于改进组和对照组,与改进组、对照组的差异具有统计学意义(F值分别为36.352、235.848,P值均<0.01).结论双上肢均不能上举患者做胸腹部CT扫描时,在常规扫描参数下,只需改变双上肢和胸椎的相对位置,使三者不在同一条直线上,伪影就会明显减轻或消失. 目的探討減輕和消除雙上肢均不能上舉患者胸腹部CT圖像偽影的掃描技術,提高圖像質量.方法選取2004年3月至2009年5月間行胸腹部CT檢查的雙上肢均不能上舉患者61例.2007年6月前31例雙上肢均不能上舉患者按常規體位行CT掃描(常規組,雙上肢自然放置于身體兩側),分析胸腹部CT圖像偽影的錶現和髮生機理.2007年6月以後的30例患者採用改進後的技術行CT掃描(改進組,改變雙上肢和胸椎的相對位置,使他們不在同一條直線上),同時選取30例雙上肢均能上舉患者(對照組)進行比較.由2名CT主管技師和1名影像診斷副主任醫師在不知道掃描方法的情況下對3組患者圖像偽影進行雙盲法評價分級(分為嚴重、較重、中、輕和無5級),測量3組患者圖像偽影區和非偽影區的肝髒CT值和圖像譟聲值,併計算齣平均值.3組患者圖像偽影分級評價結果比較採用χ~2檢驗,肝髒CT值和圖像譟聲差異比較採用單因素方差分析.結果常規組嚴重偽影11例、較重偽影15例、中度偽影5例;改進組中度偽影6例、輕度偽影15例、無偽影9例;對照組輕度偽影8例、無偽影22例,改進組的圖像質量明顯優于常規組(χ~2=95.32,P<0.01).無偽影區肝髒CT值和圖像譟聲值常規組分彆為(54.5±3.0)HU和10.7±2.4,改進組為(52.0±3.5)HU和10.7±0.5,對照組為(53.7±3.1)HU和9.9±0.5.偽影區肝髒CT值和圖像譟聲值常規組分彆為(41.7±8.4)HU和17.9±2.6,改進組的為(53.1±6.9)HU和11.0±0.7,對照組為(54.1±2.4)HU和9.9±0.5.常規組圖像偽影區的肝髒CT值和圖像譟聲變化範圍明顯增大,譟聲平均值也大幅增加,明顯高于改進組和對照組,與改進組、對照組的差異具有統計學意義(F值分彆為36.352、235.848,P值均<0.01).結論雙上肢均不能上舉患者做胸腹部CT掃描時,在常規掃描參數下,隻需改變雙上肢和胸椎的相對位置,使三者不在同一條直線上,偽影就會明顯減輕或消失.
목적 탐토감경화소제쌍상지균불능상거환자흉복부CT도상위영적소묘기술,제고도상질량.방법 선취2004년3월지2009년5월간행흉복부CT검사적쌍상지균불능상거환자61례.2007년6월전31례쌍상지균불능상거환자안상규체위행CT소묘(상규조,쌍상지자연방치우신체량측),분석흉복부CT도상위영적표현화발생궤리.2007년6월이후적30례환자채용개진후적기술행CT소묘(개진조,개변쌍상지화흉추적상대위치,사타문불재동일조직선상),동시선취30례쌍상지균능상거환자(대조조)진행비교.유2명CT주관기사화1명영상진단부주임의사재불지도소묘방법적정황하대3조환자도상위영진행쌍맹법평개분급(분위엄중、교중、중、경화무5급),측량3조환자도상위영구화비위영구적간장CT치화도상조성치,병계산출평균치.3조환자도상위영분급평개결과비교채용χ~2검험,간장CT치화도상조성차이비교채용단인소방차분석.결과 상규조엄중위영11례、교중위영15례、중도위영5례;개진조중도위영6례、경도위영15례、무위영9례;대조조경도위영8례、무위영22례,개진조적도상질량명현우우상규조(χ~2=95.32,P<0.01).무위영구간장CT치화도상조성치상규조분별위(54.5±3.0)HU화10.7±2.4,개진조위(52.0±3.5)HU화10.7±0.5,대조조위(53.7±3.1)HU화9.9±0.5.위영구간장CT치화도상조성치상규조분별위(41.7±8.4)HU화17.9±2.6,개진조적위(53.1±6.9)HU화11.0±0.7,대조조위(54.1±2.4)HU화9.9±0.5.상규조도상위영구적간장CT치화도상조성변화범위명현증대,조성평균치야대폭증가,명현고우개진조화대조조,여개진조、대조조적차이구유통계학의의(F치분별위36.352、235.848,P치균<0.01).결론 쌍상지균불능상거환자주흉복부CT소묘시,재상규소묘삼수하,지수개변쌍상지화흉추적상대위치,사삼자불재동일조직선상,위영취회명현감경혹소실.
Objective To explore a new scanning technique to reduce and avoid image artifacts of thoracoabdominal CT and improve image quality for patients who cannot raise their arms. Methods Sixty-one patients with arm-raising disability between March 2004 and May 2009 were enrolled in the study. Thirty-one cases before June 2007 were scanned with their arms beside their body (control group), 30 cases after June 2007 were scanned with their arms shifting to different imaging planes of the spine(study group), and another 30 patients who can raising their arms were taken as routine group. The images artifacts were blindly evaluated by 5-points scale (severe, less severe, moderate, minimum and no artifact) by 2 experienced CT technologists and one radiologist and compared between the three groups (χ~2 test). CT values and its noise of the liver with or without artifact of the three groups were measured and analyzed by one-way ANOVA test. Results In the control group, 11 cases had severe, 15 cases had less severe, 5 cases had moderate. In the study group, 6 cases had moderate, 15 cases had minimum, 9 cases had no artifact. In the routine group, 8 cases minimum and 22 cases had no artifact. Image quality was significantly improved in the study group compared to the conventional group where χ~2 = 95.32 and P <0.01. CT value and the noise of the liver without artifact were (54.5±3.0) HU and 10. 7±2.4 in the control group, (52.0±3.5) HU and 10.7±0.5 in the study group, (53.7±3.1) HU and 9.9±0.5 in the routine group, respectively. CT value and noise of the liver with artifact were (41.7±8.4) HU and 17.9±2.6 in control group, (53.1±6.9) HU and 11.0±0.7 in the study group, (54.1±2.4) HU and 9.9±0.5 in the routine group, respectively. The CT value and its noise variation with artifact were significantly higher in the control group than the study group and the control group, where F = 36.352,235. 848, respectively and P <0.01. Conclusion The image quality can be improved and the artifact can be minimized for the patients with arm-raising disability by shifting their arm position to the different imaging planes of the spine.