CAJ | 학술논문

目的：探索脑血管病变头颈联合CT血管造影术（CTA）检查的最适管电流。方法分别收集体质量指数（BMI）＞25 kg/m2及BMI＜25 kg/m2患者的CTA横断面图像各15例，通过图像空间添加噪声软件分别模拟出500、400、300、200、100 mA 5种管电流影像，根据影像质量及病灶显示的情况进行评价，找出满足诊断需求的最适管电流后进行临床应用。同时记录容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）。图像质量按血管边缘的锐利度及3、4级血管的显示情况而采用1~5分的评分制。等级资料使用秩和检验进行统计分析，计数资料采用χ2检验。结果 A组原始图像可清晰显示非钙化斑块37枚、混合斑块23枚、血管狭窄58段及动脉瘤6枚；B组原始图像可清晰显示非钙化斑块22枚、混合斑块11枚、血管狭窄44段、1段血管闭塞及动脉瘤4枚。不同剂量的图像质量差异有统计学意义（P＜0．05）。A组当管电流降至200 mA时，上述所有临床征象仍可清晰显示和准确诊断，图像质量评分5分2例，4分5例，3分5例，2分1例，当模拟管电流降至300 mA时，4分5例、5分10例，且同常规剂量差异无统计学意义（P＞0．05）；B组当管电流降至100 mA时，上述所有临床征象仍可清晰显示和准确诊断，图像质量评分5分1例，4分7例，3分6例，2分1例，当模拟管电流降至200 mA时，4分5例、5分10例，且同常规剂量差异无统计学意义（P＞0．05）。临床应用300 mA及200 mA管电流检查BMI＞25 kg/m2及BMI＜25 kg/m2的头颈血管，图像评分分别为4分3例、5分12例；4分1例、5分12例；4分4例、5分11例；4分2例、5分13例，与常规剂量组的图像质量评分无差异，且CTDIvol及DLP有明显降低。结论进行头颈联合CTA检查时，BMI＞25 kg/m2的患者最适的低管电流为300 mA，BMI＜25 kg/m2的患者最适的低管电流为200 mA，并可以明显降低辐射剂量。（300 mA, BMI＞25 kg/m2）and 5 point in 11、4 point in 4（200 mA, BMI＞25 kg/m2）,5 point in 13、4 point in 2（200 mA, BMI＞25 kg/m2）． There was no statistically significant between regulay dose scans(P＞0．05), CTDIvol and DLP was observably reduced． Conclusion In the examination of head and neck CTA , the optimal tube current of the BMI＜25 kg/m2 is 300mA, and 200mA in BMI＞25 kg/m2．目的：探索腦血管病變頭頸聯閤CT血管造影術（CTA）檢查的最適管電流。方法分彆收集體質量指數（BMI）＞25 kg/m2及BMI＜25 kg/m2患者的CTA橫斷麵圖像各15例，通過圖像空間添加譟聲軟件分彆模擬齣500、400、300、200、100 mA 5種管電流影像，根據影像質量及病竈顯示的情況進行評價，找齣滿足診斷需求的最適管電流後進行臨床應用。同時記錄容積CT劑量指數（CTDIvol）、劑量長度乘積（DLP）。圖像質量按血管邊緣的銳利度及3、4級血管的顯示情況而採用1~5分的評分製。等級資料使用秩和檢驗進行統計分析，計數資料採用χ2檢驗。結果 A組原始圖像可清晰顯示非鈣化斑塊37枚、混閤斑塊23枚、血管狹窄58段及動脈瘤6枚；B組原始圖像可清晰顯示非鈣化斑塊22枚、混閤斑塊11枚、血管狹窄44段、1段血管閉塞及動脈瘤4枚。不同劑量的圖像質量差異有統計學意義（P＜0．05）。A組噹管電流降至200 mA時，上述所有臨床徵象仍可清晰顯示和準確診斷，圖像質量評分5分2例，4分5例，3分5例，2分1例，噹模擬管電流降至300 mA時，4分5例、5分10例，且同常規劑量差異無統計學意義（P＞0．05）；B組噹管電流降至100 mA時，上述所有臨床徵象仍可清晰顯示和準確診斷，圖像質量評分5分1例，4分7例，3分6例，2分1例，噹模擬管電流降至200 mA時，4分5例、5分10例，且同常規劑量差異無統計學意義（P＞0．05）。臨床應用300 mA及200 mA管電流檢查BMI＞25 kg/m2及BMI＜25 kg/m2的頭頸血管，圖像評分分彆為4分3例、5分12例；4分1例、5分12例；4分4例、5分11例；4分2例、5分13例，與常規劑量組的圖像質量評分無差異，且CTDIvol及DLP有明顯降低。結論進行頭頸聯閤CTA檢查時，BMI＞25 kg/m2的患者最適的低管電流為300 mA，BMI＜25 kg/m2的患者最適的低管電流為200 mA，併可以明顯降低輻射劑量。（300 mA, BMI＞25 kg/m2）and 5 point in 11、4 point in 4（200 mA, BMI＞25 kg/m2）,5 point in 13、4 point in 2（200 mA, BMI＞25 kg/m2）． There was no statistically significant between regulay dose scans(P＞0．05), CTDIvol and DLP was observably reduced． Conclusion In the examination of head and neck CTA , the optimal tube current of the BMI＜25 kg/m2 is 300mA, and 200mA in BMI＞25 kg/m2．
목적：탐색뇌혈관병변두경연합CT혈관조영술（CTA）검사적최괄관전류。방법분별수집체질량지수（BMI）＞25 kg/m2급BMI＜25 kg/m2환자적CTA횡단면도상각15례，통과도상공간첨가조성연건분별모의출500、400、300、200、100 mA 5충관전류영상，근거영상질량급병조현시적정황진행평개，조출만족진단수구적최괄관전류후진행림상응용。동시기록용적CT제량지수（CTDIvol）、제량장도승적（DLP）。도상질량안혈관변연적예리도급3、4급혈관적현시정황이채용1~5분적평분제。등급자료사용질화검험진행통계분석，계수자료채용χ2검험。결과 A조원시도상가청석현시비개화반괴37매、혼합반괴23매、혈관협착58단급동맥류6매；B조원시도상가청석현시비개화반괴22매、혼합반괴11매、혈관협착44단、1단혈관폐새급동맥류4매。불동제량적도상질량차이유통계학의의（P＜0．05）。A조당관전류강지200 mA시，상술소유림상정상잉가청석현시화준학진단，도상질량평분5분2례，4분5례，3분5례，2분1례，당모의관전류강지300 mA시，4분5례、5분10례，차동상규제량차이무통계학의의（P＞0．05）；B조당관전류강지100 mA시，상술소유림상정상잉가청석현시화준학진단，도상질량평분5분1례，4분7례，3분6례，2분1례，당모의관전류강지200 mA시，4분5례、5분10례，차동상규제량차이무통계학의의（P＞0．05）。림상응용300 mA급200 mA관전류검사BMI＞25 kg/m2급BMI＜25 kg/m2적두경혈관，도상평분분별위4분3례、5분12례；4분1례、5분12례；4분4례、5분11례；4분2례、5분13례，여상규제량조적도상질량평분무차이，차CTDIvol급DLP유명현강저。결론진행두경연합CTA검사시，BMI＞25 kg/m2적환자최괄적저관전류위300 mA，BMI＜25 kg/m2적환자최괄적저관전류위200 mA，병가이명현강저복사제량。（300 mA, BMI＞25 kg/m2）and 5 point in 11、4 point in 4（200 mA, BMI＞25 kg/m2）,5 point in 13、4 point in 2（200 mA, BMI＞25 kg/m2）． There was no statistically significant between regulay dose scans(P＞0．05), CTDIvol and DLP was observably reduced． Conclusion In the examination of head and neck CTA , the optimal tube current of the BMI＜25 kg/m2 is 300mA, and 200mA in BMI＞25 kg/m2．
Objective To explore the optimal tube current of head and neck CTA examination in cerebrovascu-lar lesions. Methods Collected BMI>25 kg/m2 and BMI<25 kg/m2 patients of CTA cross-sectional images (n=15), Noise was artificially introduced to the axial images using an image space noise addition tool to simulate 5 sets of low-er dose scans with tube current of 500、400、300、200 and 100 mA,to evaluate in the respects of image quality and le-sion show,The determined lowest tube current was then validated using clinical scans. And record the CTDIvol and DLP.The quality of image was evaluated according to the sharpness of blood vessel edge and the display of level 3,4, blood vessels into 1-5 score.Rank sum test and χ2 test were used for statistics. Results In group of BMI>25 kg/m2, the original image could clearly show 37 cases of calcified plaques, 23 of mixed plaques, 58 of angiostenosis and 6 of arterial aneurysms.For BMI<25 kg/m2, 22 cases of calcified plaques, 11 of mixed plaques, 44 of angiostenosis, 1 vas-cular occlusion and 4 of arterial aneurysms. Different doses of the image quality had statistical significance ( P<0.05). In group of BMI>25,when the tube current was reducing to 200 mA, all the above clinical signs also could clear dis-play and accurate diagnosis.And score for image quality, 5 point in 2,4 point in 5,3 point in 5 and 2 point in 1. At the simulated dose of 300 mA,5 point in 10,4 point in 5.There was no statistically significant between regulay dose scans (P>0.05). Therefore, In BMI<25 kg/m2,100 mA(5 point in 1,4 point in 4, 3 point in 6 and 2 point in 1)and the tube current was reducing to 200 mA(5 point in 10,4 point in 5).There was no statistically significant between regulay dose scans (P>0.05). In clinical,to check the head and neck vissel for patien of BMI>25 kg/m2 and BMI<25 kg/m2 by 300 mA and 200 mA tube current. There were 5 point in 12、4 point in 3(300 mA, BMI>25),5 point in 12、4 point in 1 (300 mA, BMI>25 kg/m2)and 5 point in 11、4 point in 4(200 mA, BMI>25 kg/m2), 5 point in 13、4 point in 2(200 mA, BMI>25 kg/m2). There was no statistically significant between regulay dose scans(P>0.05), CTDIvol and DLP was observably reduced. Conclusion In the examination of head and neck CTA , the optimal tube current of the BMI<25 kg/m2 is 300mA, and 200mA in BMI>25 kg/m2.