螺旋CT颈椎低剂量扫描及重建的临床价值评价

目的:探讨螺旋CT颈椎低剂量扫描及重建的临床价值及其可行性。方法:将需行颈椎椎体扫描的患者30例,随机分为常规剂量组和低剂量组,其中常规剂量组(CDG)10例,低剂量组(LDG)20例;并选择同期行椎间盘扫描患者20例作为对照组(CG),记录辐射剂量、有效剂量,原始图像及重建图像均传输至PACS系统,由2位经验丰富的放射科医师对图像质量进行评分;测量椎体周围肌肉及背景(空气)的CT值。采用F检验进行统计分析。结果:LDG的容积CT剂量指数(CTDIv-ol)为6.5 mGy,剂量长度积(DLP)为(98.21±2.47)mGycm,有效剂量(ED)为(0.53±0.01)mSv;CDG的CTDIvol为19.1 mGy,DLP为(287.84±27.94)mGycm,ED为(0.53±0.01)mSv;CG的CTDIvol为26.5 mGy,DLP为106.0 mGycm,ED为0.57 mSv。统计分析发现,CDG与LDG、CDG与CG的DLP差异有统计学意义(P=0.000);LDG与CG的DLP差异无统计学意义(P=0.326)。CDG与LDG、CDG与CG的ED差异有统计学意义(P=0.000);LDG与CG的ED差异无统计学意义(P=0.326)。椎体扫描低剂量组的辐射剂量少于常规剂量组。LDG原始图像得分为(4.48±0.24)分;CDG的原始图像得分为(4.60±0.23)分;CG图像得分为(4.51±0.19)分。组间比较椎间盘的图像评分差异无统计学意义(P0.05),LDG的图像得分均高于4分。LDG的肌肉组织及背景(空气)CT值的标准差(SD肌肉=6.1;SD背景=20.5)均大于CG(SD肌肉=3.2;SD背景=13.9)和CDG(SD肌肉=5.8;SD背景=2.3)。结论:采用螺旋CT行颈椎椎体扫描并重建具有可行性。优化参数可以明显减少辐射剂量。与单纯椎间盘扫描相比,该检查方法并没有增加患者的辐射剂量,而提供的信息却大大增加,因此更具有临床价值。

Clinical value of spiral CT low-dose scan and reconstruction in cervical spine

Objective：To evaluate the clinical value and the accuracy of the spiral CT low-dose scan and reconstruction in the cervical spine. Methods： Thirty cases were included in the cervical vertebral CT scan group,all cases randomly divided into two groups. 10 cases in conventional dose group （CDG） and 20 cases of low-dose group（LDG） ;20 cases underwent cervical interverlebral discs CT scan at the same period were selected as control（CG）. Record the CTDIvol value,Di.P value,and effective dose （ED）. All the images, including the original images and post processing images, were transmitted into PACS system. Image quality was assessed by the two experienced senior radiologist. Measured the CT value of the muscle tissue and background （air）. F test was used for statistical analysis. Results：The CTDIvol value of the LDG was 6.5mGy,DLP value （98.21±2.47） mGycm. ED value （0.53±0.01） roSy,and the CDG were 19. lmGy,（287.84±27. 94）mGycm,and （0. 53±0. 01）mSv. The CT DIvol value of the CG was 26.5mGy,DLP value 106.0mGycm,ED value 0.57mSv. The DLP values of the CDG and LDG,the CDG and CG were significamly different （ P =0. 000）; the difference between the DLP values of the LDG and CG was not significant （ P =0. 326）. The ED values of the CDG and LDG,the CDG and CG were significantly different （ P =0. 000）; the difference of ED value of the LDG and CG was not significant （ P =0. 326）. The radiational dose of the LDG was less than that of the CDG. The scores for the original image of the LDG was （4.48±0.24） points,and the score of the CDG were （4.60±0.23） points. The image score of the CG was （4.51 ±0. 19） points. The scores between the three groups were not significantly different （ P 〉0.05）. Scores of LDG images were more than 4 ,indicating all of the images had a diagnostic value. The SD of CT value of the muscle tissue and background （air） of LDG （SDmuscle= 6.1 ;SDbackground = 20. 5）was higher than that of CG （ SI）muscle = 3.2 ; SDhackg round = 13.9 ） and CDG （ SDmuscle = 5.8 ; SDbackground = 2.3 ）. Conclusion： The spiral CT low-dose scan and reconstruction Jn the cervical spine has no increase in radiation dose but great increase in provided information compared with the cervical intervertebral discs CT scan, this method is of great clinic value.