本文選題：關(guān)節(jié) + CT��； 參考：《吉林大學》2013年碩士論文

【摘要】：目的：在256層螺旋CT上設(shè)置不同管電流、電壓條件掃描，比較在不同劑量條件下所得的圖像質(zhì)量，以評價踝腕關(guān)節(jié)低劑量掃描對關(guān)節(jié)正常結(jié)構(gòu)顯示及其圖像質(zhì)量的影響，從而探討256層螺旋CT踝腕關(guān)節(jié)低劑量掃描的可行性及其臨床價值。 方法：收集在2012年9月到2013年9月在某市三甲級某醫(yī)院進行CT檢查的成年人患者106人（130腕、踝）的相關(guān)材料，調(diào)查排除可能的骨質(zhì)密度異常人員（長期酗酒、3個月內(nèi)曾經(jīng)大量應(yīng)用激素、絕經(jīng)后女性、糖尿病病史、70歲以上老年人等）�；颊叻譃閷嶒灲M、對照組。各組受檢者年齡、性別無顯著差異。采用PHILIPS256層iCT螺旋CT進行成像掃描。由于踝、腕關(guān)節(jié)骨結(jié)構(gòu)及軟組織結(jié)構(gòu)的厚度及密度相似，故使用相同掃描參數(shù)：掃描野250mm，掃描長度150mm，層厚1.4mm，矩陣768×768，常規(guī)劑量條件120kV/240mAs（對照組，30例），低劑量條件組（實驗組）100kV/100mA（s30例）、100kV/80mAs（30例）、100kV/60mAs（30例）、80kV/60mAs（10例）。掃描劑量由螺旋CT掃描窗中給出的CT劑量指數(shù)（CTDIvol）、劑量長度乘積（DLP）給出（經(jīng)過機器自帶水模測量并校正）。后處理工作站為IntelliSpace Portal V4.0.1。對所得原始數(shù)據(jù)進行重建處理后，以同層面感興趣區(qū)測得CT值，計算標準差（SD）記為客觀評分，由兩位放射科專家以雙盲的方式對各掃描劑量條件下所得圖像進行主觀評分，用統(tǒng)計軟件對所得分數(shù)進行數(shù)據(jù)分析。 結(jié)果：其中80kV/60mAs組，主觀評分2.65±0.53，噪聲為43.83±7.17，實驗中圖像滿意度較差，采集10例樣本后放棄。當掃描條件為120kV/240mAs、100kV/100mAs、100kV/80mAs、100kV/60mAs、80kV/60mAs時，DLP分別為235.74±17.34、43.94±6.33、40.88±4.17、26.48±3.41、18.19±1.72，主觀評分為3.97±0.16，3.58±0.51，3.29±0.46，3.06±0.27，2.65±0.53，客觀評分（噪聲）分別為7.76±1.68、10.18±3.97、23.03±4.17、34.88±6.27、43.83±7.17。各實驗組較各對照組、各實驗組組間主客觀評分有顯著差異（P＜0.05）。100kV/100mAs、100kV/80mAs、100kV/60mAs較對照組圖像，在骨質(zhì)、軟組織、偽影及噪聲、三維重建方面等主觀分略有下降，但是得分均值在3分以上，其中100kV/100mAs、100kV/60mAs各有一例三維重建圖像內(nèi)部細節(jié)顯示欠清；客觀評分SD值升高。 結(jié)論：與常規(guī)掃描條件120kV/240mAs下的圖像相比，當掃描條件降至80kV/60mAs，患者劑量降至18.19±1.72mGy·cm，圖像質(zhì)量主觀評分2.65±0.53，已不足以滿足診斷需要。當掃描條件降至100kV/60mAs，，患者劑量降至26.48±3.41mGy·cm，主觀評分為3.06±0.27， CT三維圖像質(zhì)量大多處于良好級水平，優(yōu)級圖像比例降低，但低劑量下的橫斷及三維圖像能夠較好顯示解剖關(guān)系，能準確顯示踝、腕關(guān)節(jié)創(chuàng)傷空間信息，符合臨床需要，并保護了患者。
[Abstract]:Objective: to compare the image quality of 256-slice spiral CT with different current and voltage conditions, and to evaluate the effect of low-dose scan on the normal structure and image quality of ankle and wrist joint. To explore the feasibility and clinical value of 256-slice spiral CT low-dose scan of ankle and wrist joint. Methods: the data of 130 wrists and ankles of 106 adult patients who underwent CT examination in a hospital of Grade A in a city from September 2012 to September 2013 were collected. The study ruled out possible bone density abnormalities (chronic alcoholism, heavy use of hormones within 3 months, postmenopausal women, diabetic history and older persons over 70 years of age). The patients were divided into experimental group and control group. There was no significant difference in age and sex among the three groups. PHILIPS256 slice iCT spiral CT was used to scan. Because of the similar thickness and density of ankle and wrist bone structure and soft tissue structure, Therefore, the same scanning parameters were used: scanning field 250 mm, scanning length 150 mm, slice thickness 1.4 mm, matrix 768 脳 768, routine dose condition 120 kV / 24 0 mAs( control group, 30 cases, control group, 100 kV / 100 mAgs, 30 cases, 100 kV / 80 mASC, 30 cases, 100 kV / 60 MV / 60 mAsC, n = 10, n = 10). The scanning dose is given by the CT dose index (CTDIvoll) given in the spiral CT scanning window, the dose length product (DLP) (measured and corrected by the water model of the machine). The post processing workstation is IntelliSpace Portal V4.0.1. After the original data were reconstructed, the CT values were measured in the same area of interest, and the standard deviation was calculated as an objective score. The images were scored subjectively by two radiologists in a double-blind manner. The data of the score were analyzed by statistical software. Results: in the 80kV/60mAs group, the subjective score was 2.65 鹵0.53 and the noise was 43.83 鹵7.17.The image satisfaction was poor in the experiment, and 10 samples were collected and abandoned. When the scanning condition was 120kV / 240mAsL / 100kV / 100mAsL / 100kV / 80mAsL / 80kV / 80kV / 60mAS-80kV / 60mAs, respectively, the DLP was 235.74 鹵17.34nb 43.94 鹵6.33ng 40.88 鹵4.1736.48 鹵3.4118.19 鹵1.72, subjective score was 3.97 鹵0.16h3.58 鹵0.513.29 鹵0.276kV 3.06 鹵0.272.65 鹵0.53, objective score (noise) was 7.76 鹵1.6810.18 鹵3.9710.18 鹵3.974.88 鹵6.2734.88 鹵6.2734.88 鹵7.173.83 鹵7.17173.83 respectively. The subjective and objective scores of each experimental group were significantly different from those of the control group (P < 0.05) .100kV / 100mAs-100kV / / 80mAs-100kV / 60mAs were slightly lower than those of the control group in terms of bone, soft tissue, artifact, noise, 3D reconstruction, and so on, but the average score was more than 3 points. Among them, 100kV / 100kV / 100kV / 60mAs each had an incomplete internal detail of 3D reconstruction image, and the objective score of SD was increased. Conclusion: when the scanning condition is reduced to 80 kV / 60 mAs, the patient dose decreases to 18.19 鹵1.72mGy cm and the subjective score of image quality is 2.65 鹵0.53, which is not enough to meet the need of diagnosis. When the scanning condition was reduced to 100 kV / 60 mAs, the patient dose was reduced to 26.48 鹵3.41mGy cm, and the subjective score was 3.06 鹵0.27. The quality of 3D CT images was mostly at a good level, and the proportion of superior images decreased, but the cross-sectional and three-dimensional images at low dose could better display the anatomic relationship. Can accurately display ankle, wrist joint trauma space information, meet the clinical needs, and protect the patient.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R816.8

【參考文獻】

相關(guān)期刊論文 前9條

1 王榮福;;PET/CT新技術(shù)應(yīng)用[J];CT理論與應(yīng)用研究;2009年04期

2 張棟青;柳澄;;CT低劑量掃描研究進展[J];中國中西醫(yī)結(jié)合影像學雜志;2013年02期

3 羅小平;趙余祥;張海榮;劉秀祥;徐偉峰;翁新茫;翁超寅;祝敏艷;李春怡;;鼻竇低劑量CT掃描的應(yīng)用研究[J];現(xiàn)代中西醫(yī)結(jié)合雜志;2007年10期

4 陳圖敏;仇燁;;組織多普勒成像與其他超聲技術(shù)聯(lián)合應(yīng)用的進展[J];醫(yī)學綜述;2012年02期

5 蔣瑾;付凱;;磁共振成像技術(shù)現(xiàn)狀[J];實用醫(yī)院臨床雜志;2006年02期

6 劉樹錚;低劑量輻射興奮效應(yīng)發(fā)生機理若干問題的探討[J];中華放射醫(yī)學與防護雜志;2003年06期

7 亓恒濤;秦維昌;柳澄;王道才;劉傳亞;王巍;;64層螺旋CT顳骨低劑量掃描的初步研究[J];中華放射學雜志;2007年02期

8 趙勇,李品江;CT噪聲和偽影對成像質(zhì)量的影響及控制[J];中華放射學雜志;1997年01期

9 丁娟;孫鋼;李敏;李國英;朱仕芳;李勝輝;李理;;320排CT低劑量CTA評價顱內(nèi)動脈瘤的可行性研究[J];中華臨床醫(yī)師雜志(電子版);2012年08期

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