【摘要】 目的:探讨128层螺旋CT多期低剂量CT尿路造影扫描模式在输尿管梗阻病变诊断中的应用。方法:收集2011年9月至2015年12月临床怀疑有输尿管梗阻病变行CTU检查的患者427例。病人随机分为常规组和低剂量组,其中低剂量组分3组,每组患者按体重指数(BMI)分组,其中BMI值<18.5(A组),18.5≤BMI<24(B组),BMI值≥24(C组)。低剂量组平扫、皮质期、髓质期开启CARE Dose 4D低剂量自动管电流扫描模式扫描;分泌期分别给予瘦型、标准、肥胖病人不同程度低剂量管电流模式扫描(105m As、126m As、147m As);常规剂量组4期扫描管电流为210 m As。扫描完成后记录有效m As值、剂量长度乘积(DLP),计算出有效剂量(ED)及剂量减低比值(DR),并比较两组的剂量及图像质量。结果:低剂量A、B、C三组,分别较常规组(D组)扫描期总辐射剂量平均下降约35.9%、29.8%、4.4%,差异有统计学意义(P<0.01)。两名放射科医师在对图像质量综合评分结果有很好一致性(Kappa值分别为0.74和0.61)。低剂量组和对照组得分相近,低剂量组中未发现影响诊断和有大量噪声的图像。结论:多期低剂量CTU扫描模式在不同体型患者中均取得了良好的效果,在不影响诊断质量的同时能较大幅度减低辐射剂量。扫描更加个体化、人性化,是一项有价值的检查方法。更多还原

【Abstract】 Purpose: To evaluate the value of multi-phase low dose CT urography(CTU) in diagnosis of urinary tract obstruction. Methods: Four hundred and twenty-seven patients, who were suspected with urinary tract obstruction, were enrolled in our study. All the cases were randomly divided into routine group and low-dose group. And low-dose group was divided into three groups, group A, group B and group C, which were stratified by body mass index(BMI). BMI of group A was less than 18.5, that of group B was between 18.5 and 24, and that of group C was larger than 24. CARE Dose 4D technique was used for the low-dose group in plain scan, cortical phase and medulla phase scans. Different low tube current(147m As, 126 m As, 105 m As) was used for the three low-dose group in secretory phase. Routine group(group D) was scanned with tube current of 210 m As. After scanning, the effective m As, dose length product(DLP) were recorded, and the effective dose(ED) and the dose reduction(DR)were calculated,the radiation dose and image quality were compared between groups.Results:Compared with group D,the effective dose were significantly reduced in group A,B and C.Dose reduction(DR)were reduced about 35.9%,29.8%,4.4%.There was statistical significant difference between routine group and low-dose group(P<0.01).Two radiologists had good consistency in the image quality assessment(Kappa value was 0.74 and 0.61).Routine group and low-dose groups achieved the similar score.Heavy image noise was not found in low-dose groups.Conclusion:The application of multi-phase low dose CTU had achieved good effect in patients with different body size.It may not only reduce the radiation dose,but also not affect the diagnosis results.It was a valuable diagnostic method.更多还原