CAJ | 학술논문

目的：探讨640层容积CT全脑血管一站式检查方案优化的可行性。方法搜集2012年9月至2013年5月在温州医科大学附属第一医院行640层CT全脑血管检查但结果未见明显异常的患者28例，分为A、B两组。 A组14例，采用厂家推荐的检查方案（方案1：19期容积扫描）；B组14例，通过改变采集间隔，合理减少扫描期相，采用一种新的检查方案（方案2：15期容积扫描）。记录检查时A、B两组的剂量长度乘积（DLP），计算有效剂量E值和脑灌注（CTP）参数以及重建脑动脉成像（CTA），并进行评价分析。 CTP图像分析感兴趣区（ROI）设为两侧额叶白质、顶叶白质、半卵圆区、基底节区、枕叶、小脑，大小（20±2）mm2。 CTA采用双盲法主观评价。结果进行统计学分析。结果（1）A、B两组DLP值分别为4233.50、3419.40 mGy· cm，B组低于A组19.23％。（2）两组不同层面左右两侧ROI区的各灌注参数的差异均无统计学意义（均P＞0.05）。两组组间上述各个对应部位的ROI区各灌注参数无明显差别（均P＞0.05）。 CTA主观评价A、B两组间的差异均无统计学意义（均P＞0.05）。结论在保证CTP参数准确性及CTA图像质量的前提下，优化的脑血管一站式检查方案可行且大幅度降低了辐射剂量，具有较大的临床应用价值。
목적：탐토640층용적CT전뇌혈관일참식검사방안우화적가행성。방법수집2012년9월지2013년5월재온주의과대학부속제일의원행640층CT전뇌혈관검사단결과미견명현이상적환자28례，분위A、B량조。 A조14례，채용엄가추천적검사방안（방안1：19기용적소묘）；B조14례，통과개변채집간격，합리감소소묘기상，채용일충신적검사방안（방안2：15기용적소묘）。기록검사시A、B량조적제량장도승적（DLP），계산유효제량E치화뇌관주（CTP）삼수이급중건뇌동맥성상（CTA），병진행평개분석。 CTP도상분석감흥취구（ROI）설위량측액협백질、정협백질、반란원구、기저절구、침협、소뇌，대소（20±2）mm2。 CTA채용쌍맹법주관평개。결과진행통계학분석。결과（1）A、B량조DLP치분별위4233.50、3419.40 mGy· cm，B조저우A조19.23％。（2）량조불동층면좌우량측ROI구적각관주삼수적차이균무통계학의의（균P＞0.05）。량조조간상술각개대응부위적ROI구각관주삼수무명현차별（균P＞0.05）。 CTA주관평개A、B량조간적차이균무통계학의의（균P＞0.05）。결론재보증CTP삼수준학성급CTA도상질량적전제하，우화적뇌혈관일참식검사방안가행차대폭도강저료복사제량，구유교대적림상응용개치。
Objective To explore the feasibility of optimized scan protocol in whole-brain vessel one-stop examination with 640-multislice computed tomography (640-MSCT) scanner.Methods A total of 28 patients undergoing whole-brain vessel examination but showing no obvious cerebral disease with 640-MSCT scanner between September 2012 and May 2013 were collected and divided into two groups of A ( n=14) and B(n=14).The recommended scan protocol (protocol 1: collecting 19 volumes)was applied in A group while the optimized scan protocol ( protocol 2:collecting 15 volumes) formulated by reducing scanning phases reasonably and changing collection intervals in B group.The dose length product ( DLP) was recorded automatically and effective dose ( E) measured.The CT perfusion ( CTP) values and computed tomographic angiography ( CTA) images were analyzed for both groups.The regions of interest ( ROI) of CTP images with area (20 ±2) mm2 were located in bilateral frontal white matter ,parietal white matter,centrum semiovate, basal ganglia,occipital lobe and cerebellum.The image quality of CTA was evaluated by two experienced radiologists using double-blind method.The results were analyzed by statistics.Results Dose length product (DLP) in B group decreased 19.23% versus A group(3 419.40 vs 4 233.50 mGy· cm).Every relative perfusion value of both sides from both groups were not statistically significant ( P>0.05 ).Every relative perfusion parameter from individual territory in both groups showed no significant differences ( P>0.05).The quality of CTA images between groups A and B were not statistically significant ( P >0.05 ).Conclusion On the premise that the accuracy of perfusion parameters and the quality of CTA images ,the optimized scan protocol in whole-brain vessel one-stop examination can obviously reduce radiation dose and it has important clinical significance.