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    能谱纯化技术在不同BMI体检者胸部CT中的应用价值

    Application of energy spectrum purification technique in chest CT of physical examiners with different BMI

      摘要
    • 摘要: 目的 探讨能谱纯化技术在不同体质量指数(BMI)体检者胸部CT检查中的应用价值,以制定更合理的胸部CT体检低剂量扫描方案。方法 选择扬州大学附属医院2020年及2021年均进行胸部CT扫描体检者100例,BMI(kg/m2)<18.5、18.5≤BMI<24、24≤BMI<28、28≤BMI<32、BMI≥32各20例。2021年扫描方案为研究组,2020年扫描方案为对照组。研究组扫描参数:管电压Sn100 kV,参考管电流为240 mAs,螺距均为1.5;对照组扫描参数:管电压100 kV,参考管电流240 mAs,螺距均为1.5;2组均采用CARE Dose 4D技术。2名医师对图像进行评价,评价一致性检验行Kappa分析,2组肺窗及纵隔窗图像质量及辐射有效剂量(ED)行方差分析及t检验,比较不同BMI体检者的辐射剂量及辐射剂量降低幅度。结果 不同BMI对照组与研究组相比,肺窗图像主观评分差异均无统计学意义(P>0.05),纵隔窗图像主观评分差异均有统计学意义(P<0.05),噪声值、对比噪声比差异均无统计学意义(P>0.05),ED差异均有统计学意义(P<0.05)。BMI<18.5、18.5≤BMI<24、24≤BMI<28、28≤BMI<32、BMI≥32研究组较对照组ED降低幅度依次为70.5%、72.2%、75.4%、77.7%、80.2%,辐射剂量降低幅度与BMI的大小成正比。结论 与传统100 kV扫描技术相比,采用能谱纯化技术在保证图像质量的同时,大大降低了胸部CT体检者的辐射剂量,且更有利于降低BMI偏高者的辐射剂量。

       

      Abstract: Objective To explore the application of energy spectrum purification technique in chest CT of physical examiners with different body mass index(BMI), so as to formulate a more reasonable low-dose scanning scheme for chest CT physical examination.Methods A total of 100 physical examiners who underwent chest CT scan in the Affiliated Hospital of Yangzhou University in 2020 and 2021 were enrolled, including 20 cases of BMI(kg/m2)<18.5, 20 cases of 18.5≤ BMI<24, 20 cases of 24≤BMI<28, 20 cases of 28≤BMI<32, and 20 cases of BMI≥32. Physical examiners using 2021 scanning scheme were set as a research group, while those with 202 scanning scheme was set as a control group. For the research group, the following scanning parameters were used: tube voltage Sn100 kV, reference tube current 240 mAs, and pitch 1.5. For the control group, tube voltage 100 kV, reference tube current 280 mAs and pitch 1.5 were used. CARE Dose 4D was utilized by both groups. The images obtained were evaluated by two physicians. Kappa analysis was performed for the evaluation consistency test. The image quality and effective dose(ED) of lung window and mediastinum window in the two groups were analyzed by variance analysis and t test, and the radiation dose and radiation dose reduction degree of different BMI examiners were compared.Results Compared with the research group, different BMI control groups showed no statistical difference in lung window image score(P>0.05), but presented statistical difference in mediastinal window image score(P<0.05). There was no statistical difference in noise value and contrast noise ratio(P>0.05). Statistical difference was found in ED value(P<0.05). Compared with the control group, different BMI research group presented 70.5%, 72.2%, 75.4%, 77.7% and 80.2% decreases in ED, respectively. The degree of radiation dose reduction was proportional to BMI.Conclusions Compared with traditional 100 kV scanning, energy spectrum purification technique can ensure the quality of images, greatly reduce the radiation dose of examiners in chest CT physical examination, which is more conducive to reduce the radiation dose of those with larger BMI.

       

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