【作者】 孙晓明；

【导师】 柳林；

【作者基本信息】 吉林大学 ， 影像医学与核医学（专业学位）， 2020， 硕士

【副题名】不同重建层厚图像对肺栓塞栓子显示效能的对比研究

【摘要】 目的:通过比较不同层厚的图像找出一个能提高影像诊断医师诊断效率和准确性、减少漏诊率的措施,从而满足影像科医生对肺栓塞快速、准确诊断要求,让临床医生有相对足够的反应时间对患者进行及时救治。材料与方法:回顾性分析吉林大学中日联谊医院2019年3月至2019年10月201名临床拟诊肺栓塞患者,通过采用第3代SOMATOM Force双源CT进行扫描,最终入组确诊肺栓塞患者为53名,以0.75mm层厚、层间距为0.5mm为基准图像的基础上重建出1.5mm、2.5mm、5.0mm3种不同层厚的图像,层间距分别为1.0mm、2.5mm及5.0mm,经2名有5年诊断经验的影像科医师诊断并记录4组不同图像各级血管肺栓塞栓子的数目及平均阅片时间,通过用SPSS20.0统计数据显示效果差异分析。结果:两位影像科医生在观察四组不同层厚图像平均阅片时间及对肺段、亚段肺栓塞栓子的显示方面一致性相同;在肺段栓塞栓子显示中0.75mm轴位基准图像与5.0mm层厚轴位图像肺栓塞栓子显示比较中有显著差异,与1.5mm、2.5mm层厚轴位图像肺栓塞栓子显示比较中没有显著差异;在亚段肺栓塞栓子显示中,0.75mm轴位基准图像与1.5mm轴位图像在肺栓塞栓子显示比较中没有明显差异,而在其它两组中有统计学差异,且明显优于2.5mm及5.0mm轴位图像,并且随着层厚的增加,阅片时间越来越长;与0.75mm、1.5mm轴位图像对比,2.5mm、5.0mm层厚轴位图像对于单个分支或亚段肺栓塞栓子显示效果较差。结论:1.5mm重建层厚CT图像既能够满足PE诊断准确性的要求,又能提高PE诊断效率,让临床医生有相对足够的反应时间对患者进行及时救治。更多还原

【Abstract】 Purpose:By comparing images with different layer thicknesses,find a measure that can improve the diagnostic efficiency and accuracy of imaging diagnosticians and reduce the rate of missed diagnosis,so as to meet the imaging doctor’s requirements for rapid and accurate diagnosis of pulmonary embolism,allowing clinicians to have relatively sufficient reaction time Treat patients in time.Materials and methods:A retrospective analysis of 201 patients with clinically suspected diagnosis of pulmonary embolism from March 2019 to October 2019 of Jilin University Sino-Japanese Lianyi Hospital,through the use of the third-generation SOMATOM Force dual-source CT scan,the final enrollment confirmed 53 patients Name,with 0.75 mm layer thickness and layer spacing of 0.5mm as the reference image group A,reconstruct images of three different layer thicknesses of 1.5mm,2.5mm and 5.0mm,the layer spacing is 1.0mm,2.5mm and 5.0mm respectively.Two radiologists with 5 years of diagnostic experience diagnosed and recorded the number and average reading time of vascular embolism emboli at various levels in 4 groups of different images,and analyzed the difference in effect by using SPSS 20.0 statistics.Result:The two radiologists were identical in observing the average reading time of the four groups of images with different layer thicknesses and the display of pulmonary embolism in the lung segment and sub-segment.There is a significant difference in the comparison of the pulmonary embolism embolism in the 5.0mm layer thick axial image,and there is no significant difference in comparison with the 1.5mm and 2.5mm layer thick axial embolism;in the sub-segment pulmonary embolism display,0.75 mm There is no obvious difference between the axial reference image and the 1.5mm axial image in the comparison of pulmonary embolism emboli,but there is a statistical difference between the other two groups,and it is significantly better than the 2.5mm and 5.0mm axial images,and with the layer thickness The increase in reading time is longer and longer;compared with the 0.75 mm and 1.5mm axial images,the 2.5mm and5.0mm layer thickness axial images are less effective for single branches or solitary pulmonary embolism.Conclusion:The 1.5mm reconstructed slice thickness CT image can not only meet the requirements of the accuracy of PE diagnosis,but also improve the efficiency of PE diagnosis,allowing clinicians to have a relatively sufficient response time to treat patients in time.更多还原