【摘要】：第一部分 目的：應(yīng)用噪聲添加軟件對(duì)已有的CTA橫斷圖像進(jìn)行空間噪聲的添加，模擬出不同管電流條件下的圖像，比較出最適的低管電流。 材料與方法：分別收集BMI25及BMI25的患者的CTA橫斷面圖像各15例，通過圖像空間添加噪聲軟件模分別擬出100、200、300、400、500mA5種低劑量影像，根據(jù)影像質(zhì)量及病灶顯示的情況進(jìn)行評(píng)價(jià)，找出滿足診斷需求的最適球管電流。圖像質(zhì)量按血管邊緣的銳利度及3、4級(jí)血管的顯示情況而采用1-5分的評(píng)分制，等級(jí)資料使用秩和檢驗(yàn)進(jìn)行統(tǒng)計(jì)分析，計(jì)數(shù)資料采用X2檢驗(yàn)。 結(jié)果：BMI25的患者的原始圖像及5組模擬圖像均可清晰顯示非鈣化斑塊37枚、混合斑塊23枚、血管狹窄58段（其中輕度狹窄42段、中度狹窄9段、重度狹窄7段）及動(dòng)脈瘤6枚；BMI25的患者的原始圖像及5組模擬圖像均可清晰顯示非鈣化斑塊22枚、混合斑塊11枚、血管狹窄44段（其中輕度狹窄29段、中度狹窄11段、重度狹窄4段）、1段血管閉塞及動(dòng)脈瘤4枚。不同劑量的圖像質(zhì)量差異有統(tǒng)計(jì)學(xué)意義(P0.05)。BMI25組中，常規(guī)管電流時(shí)得4分5例、5分10例，管電流為300mA時(shí)得4分5例、5分10例，兩者差異無統(tǒng)計(jì)學(xué)意義(P0.05)，而當(dāng)管電流降低至200mA時(shí)，圖像質(zhì)量評(píng)分5分2例，4分5例，3分5例，2分1例，常規(guī)電流與200mA組兩者差異有統(tǒng)計(jì)學(xué)意義（P0.05)；在BMI25組中，在常規(guī)管電流（649mA）時(shí)4分3例、5分12例，管電流為200mA時(shí)4分5例、5分10例，兩者差別無統(tǒng)計(jì)學(xué)意義，而當(dāng)管電流將至100mA時(shí)，圖像質(zhì)量評(píng)分5分1例，4分7例，3分6例，2分1例，常規(guī)電流與100mA組兩者差異有統(tǒng)計(jì)學(xué)意義（P0.05)。 第二部分 目的：驗(yàn)證頭頸CTA低管電流的可行性。材料及方法：分別選取30例BMI25及BMI25行頭頸聯(lián)合CTA檢查的患者，將BMI25的患者分入常規(guī)管電流（649mA）組和低電流（300mA)組，各15人；BMI25的患者分組方法同上，為常規(guī)管電流（649mA)組及低管電流（200mA)組。檢查結(jié)束后記錄CTDI和DLP的數(shù)值，得到原始圖像后，傳入工作站分別行VR重建及曲面重建，進(jìn)行圖像質(zhì)量評(píng)價(jià)，按血管邊緣的銳利程度、分支的顯示及斑塊的顯示采用1-5分的評(píng)分制。 結(jié)果：BMI25組在管電流為300mA和常規(guī)管電流時(shí)，圖像質(zhì)量評(píng)價(jià)分別有4分3例、5分12例，4分1例、5分12例，，兩者差異無統(tǒng)計(jì)學(xué)意義（P0.05)；BMI25組在管電流為200mA和常規(guī)管電流時(shí)，圖像質(zhì)量評(píng)價(jià)分別有4分4例、5分11例，4分2例、5分13例，兩者差異無統(tǒng)計(jì)學(xué)意義（P0.05)。BMI25組中低劑量組的CTDIvol值降低了47%，DLP降低了60%；BMI25組中低劑量組較常規(guī)劑量組的CTDIvol值降低了40%，DLP降低了73%。 結(jié)論：進(jìn)行頭頸聯(lián)合CTA檢查時(shí)，BMI25的患者最適的低管電流為300mA，BMI25的患者最適的低管電流為200mA，并可以明顯降低輻射劑量。
[Abstract]:The purpose of the first part is to use the noise adding software to add spatial noise to the existing CTA cross section images, to simulate the images under different current conditions, and to compare the optimal low transistor current. Materials and methods: the CTA cross-sectional images of 15 patients with BMI25 and 15 patients with BMI25 were collected respectively. The low dose images of 100200300400500mA5 were drawn up by adding noise software in the image space, and evaluated according to the image quality and the display of the lesions. Find out the optimal spherical current to meet the diagnostic requirements. According to the sharpness of the edge of the blood vessel and the display of the 3 ~ 4 grade blood vessel, the image quality was scored by 1-5 points, the rank sum test was used to analyze the grade data, and the count data was analyzed by X2 test. Results the original images and 5 simulated images of the patients with BMI25 showed 37 non-calcified plaques, 23 mixed plaques, 58 vascular stenosis segments (42 mild stenosis, 9 moderate stenosis, 7 severe stenosis) and 6 aneurysms. The original images and 5 simulated images of the patients with BMI25 could clearly show 22 non-calcified plaques, 11 mixed plaques, 44 vascular stenosis segments (29 mild stenosis, 11 moderate stenosis). 4 segments of severe stenosis) 1 segment occlusion and 4 aneurysms. In the BMI25 group, there were significant differences in image quality between the two groups (P0.05). In the BMI25 group, the conventional tube current had 4 points in 5 cases, 5 in 10 cases, 300mA in 5 cases and 5 points in 10 cases. There was no significant difference between the two groups (P0.05), but when the tube current decreased to 200mA, there was no significant difference between the two groups (P0.05). Image quality score was 5 in 2 cases, 4 in 5, 3 in 5, 2 in 1. There was significant difference between conventional current and 200mA group (P0.05), in BMI25 group, there were 4 points (3 cases) and 5 points (12 cases) in conventional tube current (649mA). There was no significant difference between the two groups when the tube current was 200mA, 5 points in 5 cases and 5 points in 10 cases. When the tube current was approaching 100mA, the image quality score was 5 in 1 case, 4 in 7 cases, 3 in 6 cases and 2 in 1 case. There was a significant difference between the conventional current and 100mA group (P0.05). The second part aims: to verify the feasibility of head and neck CTA low current. Materials and methods: 30 patients with BMI25 and BMI25 who underwent head and neck combined with CTA were divided into 649mA group and low current (300mA) group, 15 patients with BMI25 were divided into two groups. It is a conventional tube current (649mA) group and a low transistor current (200mA) group. The values of CTDI and DLP were recorded at the end of the inspection. After the original images were obtained, VR reconstruction and curved surface reconstruction were performed on the workstation respectively, and the image quality was evaluated according to the sharpness of the blood vessel edge. A 1-5 score system was used for displaying branches and plaques. Results when the tube current was 300mA and conventional current, the image quality evaluation was 4 points in 3 cases, 5 in 12 cases, 4 in 1 case, and 5 in 12 cases. There was no significant difference between the two groups (P0.05) when the tube current was 200mA and conventional tube current in the BMI25 group, there was no significant difference between the two groups (P0.05). The image quality was evaluated in 4 cases, 5 points in 11 cases, 4 points in 2 cases and 5 points in 13 cases. There was no significant difference between the two groups (P0.05) .BMI25 group reduced the CTDIvol value of low dose group by 47% and decreased by 60%. The CTDIvol value of BMI25 group was decreased by 40% compared with that of normal dose group. Conclusion: the optimal low tube current of BMI25 patients with combined head and neck CTA is 300 mAX BMI25 and the optimal low tube current is 200mA. it can significantly reduce the radiation dose.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R816

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