作　　者： (邓国辉）; (崔凤）; (姜永乐）; (徐鹏鹏）;

机构地区： 杭州市中医院放射科,310007

出　　处： 《浙江临床医学》 2017年第10期1917-1918,1924,共3页

摘　　要： 目的评价iCT迭代重建（IR）在CT肺动脉造影中成像质量，探讨IR在疑诊肺栓塞患者中应用的可行性。方法对90例临床疑诊肺动脉栓塞的患者采用PHILIPS 256层iCT行CT肺动脉造影（CTPA），患者随机分为IR组（n=45）和FBP组（n=45）。IR组患者管电压100KV、管电流100MAs的扫描，idose4（等级4）进行重建，注射对比剂40ml。FBP组患者行常规CTPA检查，管电压120KV、管电流100MAs，注射对比剂40ml，采用滤波反投影（FBP）技术重建。统计比较两组肺动脉主干、尖段（s1）和后基底段（s10）肺动脉的强化程度、图像噪声、SNR、CTDlvol、DLP、有效剂量（ED）及图像的主观质量评级。采用SPSS16．0软件，进行Student舱验、四格表Х^2检验、非参数秩和检验、Kappa一致性检验进行统计学分析。结果肺动脉主干平均CT值IR组高于FBP组（P〈0．05）；IR组SNRS1和SNRS10明显高于FBP组（P≤0．01），IR组图像噪声、CTDlvo1、DLPY2．ED均明显低于FBP纽（P≤0．01）。结论采用低剂量扫描迭代重建模式行CTPA检查能得到临床满意的CTPA图像，能满足肺栓塞诊断的要求，这种技术可以明显降低患者的辐射剂量。 Objective To evaluate the imaging quality of iterative reconstruction （ IR ） in the CT pulmonary artery angiography with iCT and investigate the feasibility of the application of IR in the patients with suspected pulmonary embolism. Methods 90 patients clinically suspected pulmonary embolism who underwent computed tomography pulmonary angiography （ CTPA ） in PHILIPS iCT were collected and randomly divided into 2 groups, IR group （ n=45 ） and FBP group （ n=45 ） , IR group were scaned in 100kV, 100mAs, 40mL contrast material, reconstructed with idose4 （grade=4） . FBP group were scaned in normal mode （ 120kV, 100mAs, 40mL contrast material ） , reconstructed with FBP. PA enhancement, image noise, SNR, CTDIvol, DLP, ED and subjective quality ratings of images were recorded and compared with the pulmonary artery trunk, apex segment （ S1 ） and posterior basal segment （ S10 ） pulmonary artery on the two groups. Using SPSS 16.0 software, the Student t test, the chi square test, the nonparametric rank sum test and the Kappa consistency test were used for statistical analysis. Results The mean CT value of the pulmonary artery trunk in the IR group was higher than that in the FBP group （P〈0.05） , SNRS1 and SNRS10 of the IR group were significantly higher than that of the FBP group （ P≤0.01 ） . CTDIvol, DLP, image noise and ED of the IR group were significantly lower than group FBP （ P≤0.01 ） . Conclusions The iterative reconstruction CTPA examination can obtain clinically satisfactory CTPA images in the low dose mode, which meets the requirement of pulmonary embolism diagnosis, and this technique can obviously reduce the radiation dose of patients.

关 键 词： 迭代重建 肺动脉造影 辐射剂量