CAJ | 학술논문

目的：探讨双源CT自动管电压选择技术联合正弦图确定迭代重组（ SAFIRE）技术，在双期腹部增强CT扫描中的应用价值。方法收集2013年3月1日至4月10日70例行双源CT腹部扫描的患者，所有患者均行动脉期和静脉期腹部增强扫描。3月1日至20日扫描的35例患者为实验组，3月21日至4月10日扫描的35例患者为对照组。实验组采用自动管电压选择技术，并分别采用滤波反投影法（ FBP）和SAFIRE技术重组获得方案A和方案B图像；对照组采用常规120 kVp扫描模式，使用FBP技术进行重组，获得方案C图像。对方案A、B、C的图像质量进行评分，并采用秩和检验进行比较；采用方差分析比较动脉期和静脉期3种重组后图像的噪声及各部位信噪比（ SNR）和对比噪声比（ CNR）；采用t检验比较对照组和实验组的辐射剂量。结果实验组和对照组患者的有效辐射剂量分别为（3.9±0.4）和（4.9±0.4） mSv，差异有统计学意义（t值＝2.315，P＝0.021），实验组较对照组下降了20.41％。方案A、B、C图像的动脉期评分分别（3.65±0.08）、（4.41±0.10）和（3.79±0.10）分，静脉期分别为（3.57±0.08）、（4.41±0.10）和（3.95±0.11），差异均有统计学意义（ Z值分别为27.587和27.436， P 值均＜0.01）。方案 A、B、C 图像的动脉期图像噪声分别为（11.96±0.33）、（8.45±0.26）和（10.38±0.26）HU，静脉期分别为（12.79±0.39）、（9.14±0.36）和（11.13±0.18）HU，差异均有统计学意义（F值分别为39.235和29.846，P值均＜0.01）。与方案A和C双期图像相比，方案B图像的SNR值和CNR值均较高；而方案A和C的SNR和CNR差异无统计学意义（ P值均＞0.05）。结论与常规腹部增强CT扫描相比，应用自动管电压选择技术联合SAFIRE重组技术可以显著降低腹部增强扫描的辐射剂量，并得到较好的图像质量。
목적：탐토쌍원CT자동관전압선택기술연합정현도학정질대중조（ SAFIRE）기술，재쌍기복부증강CT소묘중적응용개치。방법수집2013년3월1일지4월10일70례행쌍원CT복부소묘적환자，소유환자균행동맥기화정맥기복부증강소묘。3월1일지20일소묘적35례환자위실험조，3월21일지4월10일소묘적35례환자위대조조。실험조채용자동관전압선택기술，병분별채용려파반투영법（ FBP）화SAFIRE기술중조획득방안A화방안B도상；대조조채용상규120 kVp소묘모식，사용FBP기술진행중조，획득방안C도상。대방안A、B、C적도상질량진행평분，병채용질화검험진행비교；채용방차분석비교동맥기화정맥기3충중조후도상적조성급각부위신조비（ SNR）화대비조성비（ CNR）；채용t검험비교대조조화실험조적복사제량。결과실험조화대조조환자적유효복사제량분별위（3.9±0.4）화（4.9±0.4） mSv，차이유통계학의의（t치＝2.315，P＝0.021），실험조교대조조하강료20.41％。방안A、B、C도상적동맥기평분분별（3.65±0.08）、（4.41±0.10）화（3.79±0.10）분，정맥기분별위（3.57±0.08）、（4.41±0.10）화（3.95±0.11），차이균유통계학의의（ Z치분별위27.587화27.436， P 치균＜0.01）。방안 A、B、C 도상적동맥기도상조성분별위（11.96±0.33）、（8.45±0.26）화（10.38±0.26）HU，정맥기분별위（12.79±0.39）、（9.14±0.36）화（11.13±0.18）HU，차이균유통계학의의（F치분별위39.235화29.846，P치균＜0.01）。여방안A화C쌍기도상상비，방안B도상적SNR치화CNR치균교고；이방안A화C적SNR화CNR차이무통계학의의（ P치균＞0.05）。결론여상규복부증강CT소묘상비，응용자동관전압선택기술연합SAFIRE중조기술가이현저강저복부증강소묘적복사제량，병득도교호적도상질량。
Objective To investigate the impact of automatic tube voltage selection ( ATVS) and sinogram-affirmed iterative reconstruction ( SAFIRE) on image quality and radiation dose in the arterial phase (AP) and portal venous phase (PVP) abdominal dual-source CT imaging.Methods Abdomen contrast-enhanced computed tomography ( CECTs ) in 70 patients were scanned with dual-source CT.Patients were divided into study group and control group based on the scanning date.In the first 35 patients ( study group) , ATVS mode was applied; in the second 35 patients ( control group ) , the conventional fixed at 120 kVp mode was used.The imaging of the study group was reconstructed with FBP ( protocol A ) or SAFIRE ( protocol B ) respectively; the imaging of the control group was reconstructed with FBP ( protocol C).Image quality scores of the 3 protocols were assessed and compared with Rank-sum test.Analysis of variance was used to compare mean signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and image noise among the 3 protocols.Two sample t tests were used to compare the radiation dose difference.Results The effective radiation dose in the study group ( 3.9 ±0.4 ) mSv was much lower than that in the control group (4.9 ±0.4) mSv, dropped by 20.41% (t =2.315, P=0.021).The subjective rating scores in protocol A, B, C in arterial were (3.65 ±0.08), (4.41 ±0.10) and (3.79 ±0.10) point, while the subjective rating scores in venous phase were (3.57 ±0.08), (4.41 ±0.10) and (3.95 ±0.11) point.The differences were statistically significant (Z value were 27.587 and 27.436, P<0.01).The image noise of protocol A , B, C in dual-phase were ( 11.96 ±0.33 ) , ( 8.45 ±0.26 ) , ( 10.38 ±0.26 ) HU and (12.79 ±0.39),(9.14 ±0.36), (11.13 ±0.18) HU.The differences were statistically significant (F value were 39.235 and 29.846, P<0.01).Compared to protocol A and C, SNR and CNR in protocol B were much higher (P<0.01).No statistically significant differences were shown between protocol A and C in SNR and CNR ( P>0.05).Conclusion Use of ATVS and SAFIRE could reduce the radiation dose and provide better quality images compared with conventional abdominal CECT and FBP .