CAJ | 학술논문

目的在双能CT血管成像（CTA）下肢动脉检查中，根据患者体重指数（BMI）值变换mAs值，探讨降低mAs值能否达到既降低患者接受的辐射剂量又能保证图像质量，满足诊断要求的目的。方法对60例疑患有下肢动脉阻塞性疾病患者进行了了下肢双能CTA检查，所有患者按照BMI相近原则分为A、B组，每组30例。A组皆不考虑身高、体重等因素，一律按照厂家提供的原始扫描数据进行扫描；B组依据BMI不同适当降低球管的mAs值进行扫描。分别记录两组患者选定的腹主动脉、一侧髂动脉及一侧股动脉处的噪声指数值并评价两组患者的图像质量，记录其得分值，记录机器自动生成的每名患者的容积CT剂量指数（CTDIvol）。结果 A、B两组患者图像质量的优良率分别为96.7%及93.3%；图像质量评分分别为3.833±0.461及3.733±0.583；P＞0.05，两者没有统计学意义。两组患者噪声指数分别为18.183±3.058（腹主动脉）、14.633±3.212（髂动脉）、13.907±3.037（股动脉）及22.713±3.566（腹主动脉）、18.863±3.801（髂动脉）、18±3.757（股动脉），P＜0.01，B组皆高于A组，有统计学意义。两组患者的BMI值分别为22.14±2.61及22.33±2.61，P＞0.05，两者没有统计学意义。两组患者的CTDIvol值分别为8.461±0.332及4.823±1.197，P＜0.01，有统计学意义，B组患者接受的辐射剂量明显低于A组，降低约40%。结论在双能CTA下肢动脉检查中，根据患者体重指数的不同采用不同的mAs值，即采用个性化扫描方式，可以在不影响图像质量、满足诊断要求的前提下，明显降低患者的辐射剂量，减少对患者的辐射损害，建议在临床工作中使用。
목적재쌍능CT혈관성상（CTA）하지동맥검사중，근거환자체중지수（BMI）치변환mAs치，탐토강저mAs치능부체도기강저환자접수적복사제량우능보증도상질량，만족진단요구적목적。방법대60례의환유하지동맥조새성질병환자진행료료하지쌍능CTA검사，소유환자안조BMI상근원칙분위A、B조，매조30례。A조개불고필신고、체중등인소，일률안조엄가제공적원시소묘수거진행소묘；B조의거BMI불동괄당강저구관적mAs치진행소묘。분별기록량조환자선정적복주동맥、일측가동맥급일측고동맥처적조성지수치병평개량조환자적도상질량，기록기득분치，기록궤기자동생성적매명환자적용적CT제량지수（CTDIvol）。결과 A、B량조환자도상질량적우량솔분별위96.7%급93.3%；도상질량평분분별위3.833±0.461급3.733±0.583；P＞0.05，량자몰유통계학의의。량조환자조성지수분별위18.183±3.058（복주동맥）、14.633±3.212（가동맥）、13.907±3.037（고동맥）급22.713±3.566（복주동맥）、18.863±3.801（가동맥）、18±3.757（고동맥），P＜0.01，B조개고우A조，유통계학의의。량조환자적BMI치분별위22.14±2.61급22.33±2.61，P＞0.05，량자몰유통계학의의。량조환자적CTDIvol치분별위8.461±0.332급4.823±1.197，P＜0.01，유통계학의의，B조환자접수적복사제량명현저우A조，강저약40%。결론재쌍능CTA하지동맥검사중，근거환자체중지수적불동채용불동적mAs치，즉채용개성화소묘방식，가이재불영향도상질량、만족진단요구적전제하，명현강저환자적복사제량，감소대환자적복사손해，건의재림상공작중사용。
Objective To explore whether decreased radiation dose and high image quality could be achieved by switching the mAs setting according to patients’ BMI (Body Mass Index, BMI) in lower extremity DE-CTA (Dual-energy Computerized Tomographic Angiography) for diagnostic purposes. Methods There were a group of 60 patients involved in this study and suspected for lower extremity artery diseases, who undergone dual-energy CTA and were randomly divided into two groups (30 in group A and 30 in group B) on the basis of similar BMI values. Examinations of patients in group A were done with original scan parameters and regardless of factors like the height and weight of patients;in the meantime, BMI was taken into account to lower the mAs value of the tubes correspondingly when group B were scanned. Then, the noise indexes of images on their abdominal aorta, one-side iliac artery and one-side femoral artery for both groups were recorded and the image quality was calculated correspondingly. Based on these, the software SpSS16.0 could automatically generate a CTDIvol (Computerized Tomography Dose Index Volume) value for each patient. Results The high-quality image rates and image quality scores of group A and group B were 96.7%and 93.3%, 3.833 ± 0.461 and 3.733 ± 0.583 respectively. However, these data had no statistical signiifcance (p>0.05). As for noise indexes of group A and group B, values were 18.183±3.058 and 22.713±3.566 on their abdominal aorta, 14.633±3.212 and 18.863±3.801 on their iliac artery, 13.907±3.037 and 18±3.757 on their femoral artery. Since the noise indexes of group B on different locations were higher than those of group A,there was of statistical signiifcance (p<0.01). The BMI values of the two groups were 22.14±2.61 (group A) and 22.33±2.61 (Group B) with no statistical signiifcance (p>0.05). The CTDIvol value of group A was 8.461±0.332 and Group B 4.823±1.197 with statistical signiifcance (p<0.01), from which we could see that there was about 40%lower radiation dose of group B than that of group A. Conclusion Deployment of individualized mAs settings according to different BMI, as a method that could satisfy diagnostic purposes without exertion of any impact on image quality, lessened the radiation harms to patients through large decrease of radiation dose and was suggested to be practiced in dual-energy CTA examination of lower extremity arteries.