基于体重指数调整的儿童上腹部低剂量CT扫描研究(1)
【摘要】 目的：研究基于體重指数调整的儿童上腹部低剂量CT扫描方案的辐射剂量、主客观图像质量和诊断准确性。方法：对比分析不同体重指数儿童上腹部低剂量CT扫描中的差异，前瞻性分析50%自适应统计迭代重建(adaptive statistical iterative reconstruction，ASIR)常规剂量和基于体重指数调整的上腹部低剂量CT扫描方案检查，年龄1个月～14岁。使用五点量表主观评估包括噪音，清晰度，伪影和诊断可接受性在内的图像质量。结果：3名医师对图像质量主观评分的一致性大，差异无统计学意义(κ=0.76，P>0.01)。各组肝实质CT值比较差异无统计学意义(P>0.01);各组间SNR比较差异有统计学意义(P<0.01)，图像质量均可接受。基于体重指数调整的上腹部B组所有辐射剂量参数均显著较低(P<0.01)，其中A组正常高于B组正常，差异有统计学意义(P<0.01)，后者剂量减少32.5%;A组超重高于B组超重，差异有统计学意义(P<0.01)，后者剂量减少40.4%。结论：在正常体重和超重儿童中，50% ASIR重建的个性化低剂量CT扫描方案平均剂量明显低于常规剂量，而不会显著影响儿童上腹部CT检查的诊断图像质量。
【关键词】 儿童 CT 辐射剂量
doi：10.14033/j.cnki.cfmr.2020.01.022 文献标识码 B 文章编号 1674-6805(2020)01-00-03
[Abstract] Objective： To evaluate the feasibility of the radiation dose， subjective and objective image quality and diagnostic accuracy of the low-dose CT scanning scheme for the upper abdomen of children based on BMI adjustment. Method： The differences in low-dose CT scans of the upper abdomen of children with different BMI were compared， and the 50% routine adaptive statistical iterative reconstruction (ASIR) and low-dose CT scan protocol based on BMI were prospectively analyzed， ranging in age from 1 month to 14 years old. A five-point scale was used to evaluate the subjective image quality including noise， sharpness， artifact， and diagnostic acceptability. Result： Inter-observer agreement among the three radiologists was sufficient， no significant statistical difference was existed among each group (κ=0.76， P>0.01). There was no significant difference of CT values of liver parenchyma among each groups (P>0.01). The differences of SNR among each groups were statistically significant (P<0.01). The image quality in each group were acceptable. All radiation dose parameters were significantly reduced in the group B based on BMI (P<0.01). Normal weight in group A was higher than that in group B， and the differences between two groups were statistically significant (P<0.01); and the dose of the normal weight children in group B was reduced by 32.5%. Overweight in group A was higher than that in group B， and the differences between two groups were statistically significant (P<0.01)， and the dose of the overweight children in group B was reduced by 40.4%. Conclusion： In normal weight and overweight children， 50% of the personalized low-dose CT scan regimen with ASIR reconstruction was significantly lower than the routine dose， without significantly affecting the diagnostic image quality of the upper abdominal CT examination in children., http://www.100md.com(陈添峰 周文斌 吴素霞 王强)
【关键词】 儿童 CT 辐射剂量
doi：10.14033/j.cnki.cfmr.2020.01.022 文献标识码 B 文章编号 1674-6805(2020)01-00-03
[Abstract] Objective： To evaluate the feasibility of the radiation dose， subjective and objective image quality and diagnostic accuracy of the low-dose CT scanning scheme for the upper abdomen of children based on BMI adjustment. Method： The differences in low-dose CT scans of the upper abdomen of children with different BMI were compared， and the 50% routine adaptive statistical iterative reconstruction (ASIR) and low-dose CT scan protocol based on BMI were prospectively analyzed， ranging in age from 1 month to 14 years old. A five-point scale was used to evaluate the subjective image quality including noise， sharpness， artifact， and diagnostic acceptability. Result： Inter-observer agreement among the three radiologists was sufficient， no significant statistical difference was existed among each group (κ=0.76， P>0.01). There was no significant difference of CT values of liver parenchyma among each groups (P>0.01). The differences of SNR among each groups were statistically significant (P<0.01). The image quality in each group were acceptable. All radiation dose parameters were significantly reduced in the group B based on BMI (P<0.01). Normal weight in group A was higher than that in group B， and the differences between two groups were statistically significant (P<0.01); and the dose of the normal weight children in group B was reduced by 32.5%. Overweight in group A was higher than that in group B， and the differences between two groups were statistically significant (P<0.01)， and the dose of the overweight children in group B was reduced by 40.4%. Conclusion： In normal weight and overweight children， 50% of the personalized low-dose CT scan regimen with ASIR reconstruction was significantly lower than the routine dose， without significantly affecting the diagnostic image quality of the upper abdominal CT examination in children., http://www.100md.com(陈添峰 周文斌 吴素霞 王强)