摘要
目的:探讨基于腹部定位片横径的低管电流CT扫描在诊断急性阑尾炎中应用价值。方法:对临床拟诊为急性阑尾炎的患者行腹部CT检查,根据扫描定位片所测量的横径(D)分为大、中、小3组:横径较大组(D大),D大>34cm,横径中等组(D中),28cm≤D中≤34,横径较小组(D小),D小<28cm,预设的管电流分别为标准管电流(SmAs,220mAs)、0.7SmAs,0.3SmAs进行多层螺旋CT扫描,并且将管电流选为自动管电流(ACS)+动态电流调节(DOM)模式,对3组不同辐射剂量的检查图像进行影像质量评价并作出诊断,统计3组的CT容积剂量指数(CTDIvol)和剂量长度乘积(DLP),对照手术病理结果,比较3组在诊断急性阑尾炎中的效能。结果:D大、D中、D小3组患者CTDIvol值分别为(10.28±1.57)mGy、(6.59±0.91)mGy、(3.63±0.13)mGy,差异有统计学意义(F=413.53,P<0.001);DLP值分别为(419.80±40.39)mGy·cm、(235.83±11.03)mGy·cm、(138.61±6.24)mGy·cm,差异有统计学意义(F=1644.60,P<0.001);3组之间两两比较CTDIvol及DLP值差异均有统计学意义(P均<0.01);3组中急性阑尾炎的CT诊断与手术病理比较差异均无统计学意义(P均>0.05),敏感度、特异度、阳性预测值、阴性预测值及准确度分别为D大组:100%(27/27),50%(1/2),96.43%(27/28),100%(1/1),96.55%(28/29);D中组:94.29%(33/35),100%(2/2),100%(35/35),50%(2/4),94.59%(35/37);D小组:87.5%(14/16),100%(4/4),100%(14/14),66.67%(4/6),90%(18/20)。结论:基于患者腹部定位片橫径分组采用不同管电流扫描方案可以降低患者的辐射剂量,且操作方便,能用于急性阑尾炎的诊断。
Purpose:To investigate the value of low-tube current CT scan based on the transverse diameter of abdominal topogram in the diagnosis of acute appendicitis.Methods:Abdominal CT examination was performed on the patients with clinically suspected appendicitis.According to the transverse diameter(D)measured by scanning topogram,the patients with appendicitis were divided into three groups:large transverse diameter group(Dlarge),Dlarge>34cm;medium diameter group(Dmedium),28cm≤Dmedium≤34;small transverse diameter(Dsmall),Dsmall<28cm.The default tube currents were set as SmAs(220mAs),0.7SmAs,0.3SmAs,and the tube current mode was selected as automatic tube current(ACS)+dynamic current adjustment(DOM).Image quality evaluation and diagnosis were performed on the images of three groups acquired with different radiation doses.The CT volumetric dose index(CTDIvol)and dose length product(DLP)were compared with the pathological results and the efficacy of three groups in the diagnosis of acute appendicitis was compared.Results:CTDIvol values in the Dlarge,Dmedium,and Dsmall groups were 10.28±1.57 mGy,6.59±0.91 mGy,and 3.63±0.13 mGy,respectively,and the difference was with statistical significance(F=413.53,P<0.001);DLP values were 419.80±40.39(mGy·cm),235.83±11.03(mGy·cm),and 138.61±6.24(mGy·cm)respectively,and the difference was with statistical significance(F=1644.60,P<0.001).There were significant differences in CTDIvol and DLP among three groups(P<0.01).There was no significant difference between the CT diagnosis and pathological result of acute appendicitis in the 3 groups(P>0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 100%(27/27),50%(1/2),96.43%(27/28),100%(1/1),96.55%(28/29)for Dlarge,and 94.29%(33/35),100%(2/2),100(35/35),50%(2/4),94.59%(35/37)for Dmedium and 87.5%(14/16),100%(4/4),100%(14/14),66.67%(4/6),90%(18/20)for Dsmall,respectively.Conclusion:The CT scanning protocol of low-dose with different tube current based on the transverse diameter of abdominal topogram can reduce the radiation dose of the patient and be easy to operate,which can be used for the diagnosis of acute appendicitis.
作者
葛明
涂丹丹
刘振宇
苑翠红
张华明
曲良勇
钮建武
汪登斌
GE Ming;TU Dan-dan;UU Zhen-yti;YUAN Cui-hong;ZHANG Hua-ming;QU Liang-yong;NIU Jian-wu;WANG Deng-bin(Department of Radiology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine;Department of Radiology,Shanghai Zhongye Hospital)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2019年第4期375-379,共5页
Chinese Computed Medical Imaging
关键词
急性阑尾炎
辐射剂量
CT
Acute appendicitis
Radiation dosage
Computed tomography
