CAJ | 학술논문

目的探讨双源CT前瞻性心电触发大螺距扫描(简称大螺距扫描)在小儿先天性心脏病(简称先心病)中的临床应用价值.方法搜集行大螺距扫描的36例先心病患儿的影像资料,记录其剂量长度乘积(DLP),计算出有效辐射剂量(ED).由2名放射科医师在双盲的情况下独立诊断并用5分法对图像质量进行评估.2名医师对图像质量评估符合程度的评价采用Kappa检验.以手术或DSA结果为金标准,计算大螺距扫描诊断先心病的准确度、敏感度和特异度.结果 36例患儿大螺距扫描的DLP为(2.4～9.2)mGy·cm,平均(5.1±1.6) mGy·cm,ED为(0.078 ～0.179)mSv,平均(0.125±0.027) mSv.图像质量均符合诊断要求；2名放射科医师的图像质量评价一致性好(K=0.774,P＜0.05).大螺距扫描诊断先心病的准确度、敏感度、特异度分别为98.9％、94.2％、99.8％.结论双源CT大螺距扫描技术降低了受检患儿的辐射剂量,图像仍满足诊断要求,为小儿先心病的诊断提供了一种新的可供选择的方法.
목적 탐토쌍원CT전첨성심전촉발대라거소묘(간칭대라거소묘)재소인선천성심장병(간칭선심병)중적림상응용개치.방법 수집행대라거소묘적36례선심병환인적영상자료,기록기제량장도승적(DLP),계산출유효복사제량(ED).유2명방사과의사재쌍맹적정황하독립진단병용5분법대도상질량진행평고.2명의사대도상질량평고부합정도적평개채용Kappa검험.이수술혹DSA결과위금표준,계산대라거소묘진단선심병적준학도、민감도화특이도.결과 36례환인대라거소묘적DLP위(2.4～9.2)mGy·cm,평균(5.1±1.6) mGy·cm,ED위(0.078 ～0.179)mSv,평균(0.125±0.027) mSv.도상질량균부합진단요구；2명방사과의사적도상질량평개일치성호(K=0.774,P＜0.05).대라거소묘진단선심병적준학도、민감도、특이도분별위98.9％、94.2％、99.8％.결론 쌍원CT대라거소묘기술강저료수검환인적복사제량,도상잉만족진단요구,위소인선심병적진단제공료일충신적가공선택적방법.
Objective To explore the clinical value of prospective electrocardiography-triggering high-pitch spiral acquisition by dual-source CT (HP mode ) in children with congenital heart diseases (CHD).Methods Thirty-six patients ( mean age:0.67 years,range:1 month to 2 years and 6 months; 25 males;mean weight:7.7 kg)underwent prospective ECG-triggering high-pitch spiral acquisition.The dose length product (DLP) was recorded to calculate effective dose ( ED ).Two experienced radiologists made diagnosis and assessed the overall image quality by a five-point scale independently.The consistency of their judgment was determined by Kappa statistics.Surgeries were performed in 29 patients,and conventional cardiac angiography(CCA) was performed in 7 patients.The accuracy,sensitivity and specificity of HP mode were calculated based on the surgical or CCA findings.Results The DLP was (5.12 ± 1.64) mGy.cm with a range of 2.4 mGy · cm to 9.2 mGy · cm and ED was (0.125 ± 0.027 ) mSv ranging from 0.078 mSv to 0.179 mSv.The average subjective image quality score was 4.2 ± 0.7.All images were diagnosable.Two radiologists made good agreement ( K =0.774,P ＜ 0.05 ).The accuracy,sensitivity and specificity of HP mode were 98.9％,94.2％ and 99.8％,respectively.Conclusion Low radiation dose with the accurate diagnosis of anomalies makes HP mode a new choice for children with CHD.