儿童肺部CT曝光参数及其辐射剂量的比较分析

目的优化儿童肺部CT曝光参数，减少其辐射危害。方法对疑有肺部病变的儿童及青少年210例，降低曝光量行肺部CT扫描，以肺部支气管分叉层面的胸廓前后径和横径线长的平均值为依据，以儿童常规曝光量的70％为起始扫描剂量，逐次减少曝光量10mAs，观察其成像质量，直至图像质量良好，符合诊断的要求，并分析其曝光量mAs和单次扫描的CT剂量加权指数CTDIW及剂量长度乘积DLP。结果与儿童常规肺部曝光量200mAs相比，不同肺部发育的个体，其肺部CT曝光量可降低到其常规曝光量的45％～80％，单次扫描的CT剂量加权指数CTDIW及剂量长度乘积DLP均可降至27．45％～80％。结论根据儿童胸部个体发育差异，适当地降低曝光量，可以有效地降低其辐射剂量，减少其辐射危害。     

Z轴自动管电流调制技术在头颈部CT扫描血管成像中对甲状腺剂量的降低

目的 评价在进行头颈部CT扫描血管成像时,Z轴自动管电流调制技术(ATCM)对减少甲状腺的辐射剂量的作用及对图像噪声的影响。方法 回顾性地分析140例头颈部CT增强血管成像的病例,其中用固定管电流技术和 Z 轴自动管电流调节技术各70例,观察其成像质量,记录其客观噪声水平(由CT图像衰减值的标准差进行评估),并比较其单次扫描的加权CT剂量指数CTDI_w,管电流mA及剂量长度乘积DLP。结果 在扫描范围、扫描参数(管电压、螺距、准直器厚度等)、造影剂注射速率和注射部位完全相同的情况下,固定管电流技术和 Z 轴自动管电流调节技术的图像质量相同,甲状腺图像噪声分别为10.14和13.64 HU。单次扫描的加权CT剂量指数CTDI_w(mGy)分别为(43.22±1.42)和(35.99±1.31) mGy。剂量长度乘积分别为(1514.45±5.56)和(1121.39±5.51)mGy·cm, 剂量长度乘积降低约25.95%。结论 Z 轴自动管电流调节技术能有效降低总曝光量和累计剂量长度乘积,可以有效地降低患者的辐射剂量,特别是像甲状腺和眼晶体等射线敏感组织器官的辐射剂量降低,减少其辐射危害,但是图像噪声略有增加。     

双能量CT头颈部血管减影成像的效果评价及临床应用

目的：评价双能量CT在头颈部血管减影中自动去骨的效果及其临床应用价值。方法：52例临床怀疑头颈部血管疾病的患者随机分为2组,分别进行双能量CT血管减影成像和常规CT血管减影成像,分别用双能量处理软件和Neuro-DSA软件自动完成去骨,采用容积重建（VR）、最大密度投影（MIP）、多平面重组（MPR）等多种后处理方法,由两位经验丰富的放射科医生采用双盲法评价两种减影方法的去骨效果,并进行比较;同时结合非减影数据,观察血管病变情况。结果：双能量CT血管减影成像和常规CT血管减影成像的容积CT剂量指数（CTDIvol）分别为（20.5635±0.00977）mGy和（25.5746±0.55827）mGy,两者有显著性差异。两种方法对于颈动脉、椎动脉及整体头颈部血管的满意显示率分别为87.8%,68.0%,83.0%和93.5%,91.8%,92.6%,其中对于颈动脉的显示无明显差异,但双能量CT血管减影对部分椎动脉的减影效果较常规CT血管减影差,主要集中在椎动脉近颅底的部分。另外,双能量CT血管减影成像还发现了多处血管病变,临床符合率为100%。结论：相比头颈部常规CT血管减影,双能量CT血管减影辐射剂量更低,能够有效的去除绝大多数骨骼,为头颈部血管疾病的诊断提供了一种新的无创性检查方法。     

低剂量CT结肠成像的图像质量与辐射剂量评价

目的评估低剂量CT结肠成像的图像质量,并统计其辐射剂量,探讨其临床应用价值。资料与方法对51例患者进行低剂量CT结肠成像。俯卧位扫描条件为120kV,30mAs;仰卧位扫描条件为120kV,50mAs。由两名医师盲法判定两种体位CT结肠成像的图像质量。记录每例患者接受CT低剂量结肠成像时的容积CT剂量指数(CTDIvol)、剂量长度乘积(DLP),并估算出有效剂量。结果结肠的CT图像质量评分:仰卧位与俯卧位各评分点之间均无显著性差异(P>0.05),其图像质量较高;肠外实质器官的CT图像质量评分:仰卧位图像可以满足诊断需要,而俯卧位图像影响诊断和观察,两者各评分点之间有显著性差异(P<0.05)。辐射剂量测定:低剂量CT结肠成像的CTDIvol及DLP比常规腹部扫描降低了约70.7%。结论低剂量CT结肠成像降低了患者的辐射剂量,结肠及腹部实质器官的图像质量满足诊断要求。     

MSCT扫描方式对辐射剂量及图像质量影响的研究

目的 探讨多层螺旋CT(MSCT)扫描方式对辐射剂量及图像质量的影响.资料与方法 采用GE 4层螺旋CT以相同的曝光量/周及扫描范围对机器自带质量控制(QA)体模进行不同扫描方式的扫描,分别以1 s/周、0.7 s/周、2 s/周的球管旋转时间和层厚组合进行序列扫描,以不同的螺距比与层厚的组合进行螺旋扫描.辐射剂量在扫描后机器自动记录的信息中获得CT容积剂量指数(CTDIvol)、剂量长度乘积(DLP)、射线有效率;图像质量通过在体模图像上观察伪影、密度分辨率、空间分辨率、有效层厚,测量水的CT值及噪声、均匀性值等参数而得到评判.对不同扫描方式及组合的辐射剂量和图像质量参数进行比较,并对CTDIvol、DLP进行t检验.结果 轴向扫描2 s/,周各组合的CTDIvol、DLP相应降低;螺旋扫描随螺距比的增加CTDIvol及DLP降低,随层厚的增加DLP也增加,CTDIvol相等.轴向扫描(1 s/周)的CTDIvol及DLP低于螺距比为0.75:1的螺旋扫描(1 s/周),两组间的DLP差异有统计学意义(t=15.69,P＜0.05).螺旋扫描较轴向扫描的图像有明显伪影,密度分辨率更低,有效层厚大于标称层厚且边缘模糊,其他指标比较接近.结论 在曝光量/周及扫描范围相同的条件下,MSCT轴向扫描的辐射剂量较螺旋扫描更低而图像质量更高.     

低剂量对比剂在头颈部CT血管减影成像中的应用

目的：探讨低剂量对比剂在头颈部CT血管减影成像中的可行性。方法对100例进行头颈部CT血管减影成像患者随机均分成两组,常规组对比剂的注射剂量为70 mL,低剂量组注射剂量50 mL,相同的注射速率进行增强扫描,采用VR、MIP、MPR、CRP等方法重建图像并对两组的影像质量进行归类分析。结果两组间的影像质量优、良率相当,无统计学差异（ P＞0．05）。结论对多层螺旋CT而言,应用注射低剂量对比剂进行头颈部血管减影成像是可行的,可以满足临床诊断要求。     

儿童人工耳蜗植入术作CT扫描时眼球的放射防护

目的优化儿童人工耳蜗植入术前、后作颞骨CT扫描的曝光参数，减少其辐射危害。方法对疑有颞骨内耳病变者87例（其中人工耳蜗植入手术接受者31例），行颞骨薄层高分辨CT扫描（HRCT），以成人扫描参数为标准，适当调整扫描曝光量及扫描角度，直至图像符合诊断的要求，并分析其曝光量及单次扫描的加权CT剂量指数（CTDIw）和剂量长度乘积（DLP）。结果儿童颞骨CT扫描曝光量及单次扫描的CTDIw值可降低到成人曝光量的66．67％～83．33％，DLP也可降低到66．67％～83．33％，且内耳及植入电极三维重建图像质量优良。结论儿童人工耳蜗植入术前、术后作CT扫描曝光量的适当降低，以及扫描角度的适当调整，可有效地降低颞骨局部的辐射剂量，且有效地避免了儿童眼晶体的直接辐射伤害。     

扫描方式对64层螺旋CT头颅CTA图像质量和辐射剂量影响的研究

目的：探讨64层螺旋CT扫描方式对头颅CTA图像质量和辐射剂量的影响。方法：采用GE Lightspeed VCT对100例需要行头颅CTA检查的患者进行对比研究,50例行螺旋扫描,另50例行轴层扫描。两组数据经过VR、MIP、去骨VR和多平面重组等方法后处理,然后由3组医师通过5分评价法对CTA图像质量进行主观评价,取其均值纳入统计学分析;记录每组扫描的容积剂量指数（CTDIvol）和剂量长度乘积（DLP）。对两组数据进行两独立样本t检验。结果：轴向扫描图像质量评分是（4．66±0．42）分、螺旋扫描CTA的成像质量评分（4．67±0．38）分;两组数据差异无统计学意义（P〉0．05）。轴向扫描、螺旋扫描的CTDIvol分别是45．71和54．18mGy;DLP分别是731．43和954．68mGy·cm。两组间差异有统计学意义（P〈0．05）,轴层扫描方式辐射剂量更低。结论：64层CT头颅CTA轴扫可以显著降低辐射剂量而不降低图像质量,在临床运用中值得关注。     

双源CT不同扫描方式在肺动脉成像临床应用

目的 比较第一代与Flash双源CT不同扫描方式在肺动脉成像时剂量与图像质量.方法 收集120例临床疑诊为PE患者,按扫描方式随机分为4组：A组行第一代双源CT双能量扫描（80/140kV）,B组行flash双源CT双能量扫描（80/sn140kV）,C组行flash双源CT双能量扫描（100/sn140kV）,D组行flash双源CT双能量扫描（140/80kV）.比较4组间的CT容积剂量指数（CT dose volume index,CTDIvol）、剂量长度乘积（dose length product,DLP）、背景噪声和肺动脉信噪比.结果 各组间患者一般情况没有明显统计学差异.B组的CTDIvol,DLP值明显低于A、C两组,图像质量明显好于D组.结论 flash双源CT（80/sn140kV）在获得满意的图像质量的同时可以减低辐射剂量.     

低kV扫描成像应用于主动脉MSCTA的可行性研究

目的：采用低kV技术对体质量指数（body mass index,BMI）≤25的患者行主动脉MSCTA,分析扫描辐射剂量和成像质量,探讨该技术应用于BMI≤25患者主动脉MSCTA的可行性。方法：选择BMI≤25临床拟行CTA检查的患者80例,前瞻性扫描按管电压分为常规组和实验组各40例,常规组120 kV、120 mAs,实验组90 kV、120 mAs,其他扫描参数一致。2组均应用智能对比剂跟踪技术,均以剂量1.5 mL/kg体质量,流率4 mL/s注入对比剂碘海醇。读取并计算CT容积剂量指数（CTDIvol）、剂量长度乘积（DLP）、有效辐射剂量（ED）,对图像质量进行双盲法主观评价（主动脉及主要分支血管强化程度、显示清晰度、有无伪影）和客观评价［主动脉CT值、图像噪声（SD）、SNR、对比噪声比（CNR）］。结果：①实验组CTDIvol、DLP、ED明显低于常规组（均P<0.05）。②主观评分一致性较好（K>0.6）,图像质量评分均≥2分,所有患者血管及周围结构显示清晰,满足诊断要求,组间比较差异无统计学意义（P>0.05）。实验组主动脉各部血管CT值均高于常规组（均P<0.05）;实验组SD高于常规组（P<0.05）;2组SNR、CNR差异均无统计学意义（均P>0.05）。结论：BMI≤25的患者应用90 kV行主动脉CTA,可在有效降低辐射剂量的同时获得符合诊断要求的图像质量,具有较好的临床实用性和可行性。     

CT arthrography of the glenohumeral joint: CT fluoroscopy versus conventional CT and fluoroscopy--comparison of image-guidance techniques

PURPOSE: To compare examination time with radiologist time and to measure radiation dose of computed tomographic (CT) fluoroscopy, conventional CT, and conventional fluoroscopy as guiding modalities for shoulder CT arthrography. MATERIALS AND METHODS: Glenohumeral injection of contrast material for CT arthrography was performed in 64 consecutive patients (mean age, 32 years; age range, 16-74 years) and was guided with CT fluoroscopy (n = 28), conventional CT (n = 14), or conventional fluoroscopy (n = 22). Room times (arthrography, room change, CT, and total examination times) and radiologist times (time the radiologist spent in the fluoroscopy or CT room) were measured. One-way analysis of variance and Bonferroni-Dunn posthoc tests were performed for comparison of mean times. Mean effective radiation dose was calculated for each method with examination data, phantom measurements, and standard software. RESULTS: Mean total examination time was 28.0 minutes for CT fluoroscopy, 28.6 minutes for conventional CT, and 29.4 minutes for conventional fluoroscopy; mean radiologist time was 9.9 minutes, 10.5 minutes, and 9.0 minutes, respectively. These differences were not statistically significant. Mean effective radiation dose was 0.0015 mSv for conventional fluoroscopy (mean, nine sections), 0.22 mSv for CT fluoroscopy (120 kV; 50 mA; mean, 15 sections), and 0.96 mSv for conventional CT (140 kV; 240 mA; mean, six sections). Effective radiation dose can be reduced to 0.18 mSv for conventional CT by changing imaging parameters to 120 kV and 100 mA. Mean effective radiation dose of the diagnostic CT arthrographic examination (140 kV; 240 mA; mean, 25 sections) was 2.4 mSv. CONCLUSION: CT fluoroscopy and conventional CT are valuable alternative modalities for glenohumeral CT arthrography, as examination and radiologist times are not significantly different. CT guidance requires a greater radiation dose than does conventional fluoroscopy, but with adequate parameters CT guidance constitutes approximately 8% of the radiation dose.     

Patient radiation dose at CT urography and conventional urography

PURPOSE: To measure and compare patient radiation dose from computed tomographic (CT) urography and conventional urography and to compare these doses with dose estimates determined from phantom measurements. MATERIALS AND METHODS: Patient skin doses were determined by placing a thermoluminescent dosimeter (TLD) strip (six TLD chips) on the abdomen of eight patients examined with CT urography and 11 patients examined with conventional urography. CT urography group consisted of two women and six men (mean age, 55.5 years), and conventional urography group consisted of six women and five men (mean age, 58.9 years). CT urography protocol included three volumetric acquisitions of the abdomen and pelvis. Conventional urography protocol consisted of acquisition of several images involving full nephrotomography and oblique projections. Mean and SD of measured patient doses were compared with corresponding calculated doses and with dose measured on a Lucite pelvic-torso phantom. Correlation coefficient (R(2)) was calculated to compare measured and calculated skin doses for conventional urography examination, and two-tailed P value significance test was used to evaluate variation in effective dose with patient size. Radiation risk was calculated from effective dose estimates. RESULTS: Mean patient skin doses for CT urography measured with TLD strips and calculated from phantom data (CT dose index) were 56.3 mGy +/- 11.5 and 54.6 mGy +/- 4.1, respectively. Mean patient skin doses for conventional urography measured with TLD strips and calculated as entrance skin dose were 151 mGy +/- 90 and 145 mGy +/- 76, respectively. Correlation coefficient between measured and calculated skin doses for conventional urography examinations was 0.95. Mean effective dose estimates for CT urography and conventional urography were 14.8 mSv +/- 90.0 and 9.7 mSv +/- 3.0, respectively. Mean effective doses estimated for the pelvic-torso phantom were 15.9 mSv (CT urography) and 7.8 mSv (conventional urography). CONCLUSION: Standard protocol for CT urography led to higher mean effective dose, approximately 1.5 times the radiation risk for conventional urography. Patient dose estimates should be taken into consideration when imaging protocols are established for CT urography.     

Effective radiation dose from semicoronal CT of the sacroiliac joints in comparison with axial CT and conventional radiography

The aim of this study was to evaluate the radiation dose given by semicoronal CT of the sacroiliac joints (SIJs) in comparison with axial CT and conventional radiography. The total effective radiation doses given by serial contiguous semicoronal and axial CT, using 5-mm slices, 120 kV and 330 mAs, were determined by measurement of organ doses using an anthropomorphic Rando Alderson phantom paced with thermoluminescence dosimeters. The doses given by conventional antero-posterior (AP) and oblique projections of the SIJs were determined similarly. In a female the total effective dose by semicoronal CT was found to be more than six times lower than by axial CT and 2.5 times lower than the dose use to obtain a conventional AP radiograph, the values being 102, 678, and 255 μSv, respectively. The effective dose by semicoronal CT was only a little higher than the dose given to obtain two oblique radiographs. In a male with lead protection of the gonads the dose by semicoronal CT was four times lower than by axial CT, but higher than by conventional radiography. In conclusion, the effective dose by semicoronal CT of the SIJs is lower than by axial CT, and in females a semicoronal CT implies a lower effective radiation dose that used to obtain an AP radiograph. Electronic Publication     

Benefits and safety of CT fluoroscopy in interventional radiologic procedures

PURPOSE: To determine the benefits and safety of computed tomographic (CT) fluoroscopy when compared with conventional CT for the guidance of interventional radiologic procedures. MATERIALS AND METHODS: Data on 203 consecutive percutaneous interventional procedures performed with use of CT fluoroscopic guidance and 99 consecutive procedures with conventional CT guidance were obtained from a questionnaire completed by the radiologists and CT technologists who performed the procedures. The questionnaire specifically addressed radiation dose measurements to patients and personnel, total procedure time, total CT fluoroscopy time, mode of CT fluoroscopic guidance (continuous versus intermittent), success of procedure, major complications, type of procedure (biopsy, aspiration, or drainage), site of procedure, and level of operator experience. RESULTS: The median calculated patient absorbed dose per procedure and the median procedure time with CT fluoroscopy were 94% less and 32% less, respectively, than those measurements with conventional CT scanning (P <.05). An intermittent mode of image acquisition was used in 97% of the 203 cases. This resulted in personnel radiation dosimetric readings below measurable levels in all cases. CONCLUSION: As implemented at the authors' institution, use of CT fluoroscopy for the guidance of interventional radiologic procedures markedly decreased patient radiation dose and total procedure time compared with use of conventional CT guidance.     

低剂量螺旋CT检出肺结节的价值

目的 :评价低剂量螺旋CT检出肺结节的价值。材料和方法 :对 3 0例肺外恶性肿瘤肺内多发转移患者分别行低剂量螺旋CT( 5 0mA ,螺距 2 .0 )及常规螺旋CT( 2 5 0mA ,螺距 1.0 )扫描 ,采用双盲法对结节数目、大小及分布进行分析。结果 :3 0例患者采用低剂量及常规螺旋CT检出结节数分别为 872个、876个 ,二者对结节的检出无明显差异 ,部分患者低剂量螺旋CT显示的结节略小。结论 :低剂量螺旋CT与常规螺旋CT对肺结节的显示相仿 ,可用于恶性肿瘤患者术前检查及高危人群肺癌筛选。     

成人胸部多层螺旋CT低剂量扫描和防护价值

目的:探讨螺旋CT低剂量扫描在成人胸部应用的可行性和防护价值。方法:对35例近期(2周内)80mAs胸部常规剂量CT检查病例复查者,使用本机设置最低剂量(20mAs)扫描,盲式阅片评判两种扫描剂量图像对病变诊断、图片质量的差异,结果进行统计学分析。结果:当mAs从常规剂量80减低到20时,辐射剂量显著降低,CTDIvol从8.64mGy降低到2.16mGy,为原来剂量的25%。对照常规剂量组的诊断结果,低剂量组均能明确诊断,无一例漏诊或误诊。图像质量在常规剂量以优质片为主,低剂量以优和良为主,差别有显著性意义(P=0.00),说明降低扫描剂量后图像质量有所下降,但不影响疾病的诊断。结论:多层螺旋CT成人胸部低剂量扫描,对于胸部复查病例,既不影响胸部疾病的诊断,又能显著降低扫描剂量,具有显著的防护价值。     

肺部低剂量螺旋CT放射剂量的研究

目的 :评价低剂量与常规剂量螺旋CT扫描的X线放射剂量比。方法 :对肺内结节用 2 0 0mAs行常规剂量螺旋CT扫描 ,扫描参数为 :12 0kV ,层厚 10mm ,扫描间隔 10mm ,螺距 1 5。选取不同层厚 (5mm、10mm)分别用 2 0 0mA、4 0mA、30mA、2 0mA、10mA扫描 ,记录各组每次扫描的单次CT剂量加权指数CTDIw(mGy)及mAs。对所有数据进行统计学处理 ,P <0 0 5时差异有统计学意义。结果 :2 0 0mA常规剂量组之CTDIW及毫安秒值与低剂量各组 (40mA、30mA、2 0、10mA)值比较差异有统计学意义 (P <0 0 5 ) ;以 2 0 0mAs常规剂量为标准 ,其余低剂量组 4 0mA ,30mA ,2 0mA ,10mA毫安秒及CTDIw分别降低了 80 %、90 %、95 %。结论 :用 2 0mAs低剂量螺旋CT扫描毫安秒及CTDIW仅仅相当于用 2 0 0mAs的 1/10 ,辐射剂量降低了 90 %。 2 0mA是肺部扫描的最佳剂量 ,具有辐射量小、敏感性强、性价比高的特点 ,值得推广应用。     

螺旋CT检测肺结节的低剂量优化选择及应用

目的:探讨低剂量螺旋CT对肺部结节灶扫描的最佳条件及其应用价值,并评价低剂量与常规剂量螺旋CT扫描的X线放射剂量比。方法:对75例88个肺内结节分别用200mA、40mA、30mA、20mA和10mA进行螺旋CT扫描。测量结节的最大径、CT值、最大CT值,记录结节的各种内部征象、噪声和伪影及每次扫描的单次CT剂量加权指数(CTDIw)及mA。结果:5种不同管电流扫描图像所示肺内结节灶的检出率、最大径、CT值及结节的各种内部征象,各组间差异无统计学意义(P>0.05),噪声和伪影10mA组高于其它组(P<0.05),200mA常规剂量组与低剂量各组比较CTDIw值差异有显著性意义(P<0.05)。结论:20mA是肺部扫描的最佳剂量,具有辐射量小、敏感性强、性价比高的特点,值得推广应用。     

CT of the head by use of reduced current and kilovoltage: relationship between image quality and dose reduction

BACKGROUND AND PURPOSE: CT is a frequent examination that is performed using ionizing radiation. We sought to assess image-quality changes on CT scans of the head when the radiation dose is reduced by changing tube current and kilovoltage. METHODS: A formalin-fixed cadaver was examined in conventional and helical mode by use of two CT-scanners. Surface dose was measured with standard scanning parameters, and after reduction of tube current and kilovoltage. Five experienced examiners independently evaluated subjective image quality. RESULTS: In the conventional mode, the highest surface dose was 83.2 mGy (scanner 1: helical mode, 55.6 mGy), and 66.0 mGy (scanner 2: helical mode, 55.9 mGy). By changing kVp and mAs, a dose reduction of up to 75% (scanner 1), and 60% (scanner 2) was achieved. No observable differences in image quality between scans obtained with doses from 100% to 60% of standard settings were noted. Ten of 20 images obtained with the highest dose and 13 of 20 images obtained with lowest dose (19-29.4 mGy) were reliably identified by subjective quality assessment. Scans produced with a surface dose of less than 30 mGy were judged uninterpretable. CONCLUSION: Standard parameters used in cranial CT are oriented toward best image quality. A dose reduction up to 40% may be possible without loss of diagnostic image quality.