| 王艳,史大鹏,王梅云,任宇婧,孙亚平,安恒彬.双源CT大螺距结合低管电压技术术前诊断婴幼儿肺静脉异位引流[J].中国医学影像技术,2018,34(9):1400~1404 |
| 双源CT大螺距结合低管电压技术术前诊断婴幼儿肺静脉异位引流 |
| High-pitch combined with low tube voltage technique with dual-source CT in pre-operative diagnosis of infants with anomalous pulmonary venous connections |
| 投稿时间：2018-02-07 修订日期：2018-06-25 |
| DOI：10.13929/j.1003-3289.201802048 |
| 中文关键词: 体层摄影技术,X线计算机 低剂量 肺静脉异位引流 |
| 英文关键词:Tomography,X-ray computed Low-dose Anomalous pulmonary venous connections |
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| 中文摘要: |
| 目的 探讨双源CT大螺距结合低管电压技术术前诊断婴幼儿肺静脉异位引流（APVC）的价值。方法 对60例3岁以内拟诊APVC患儿于术前1周行心脏CT扫描，将其随机均分为A组、B组。A组管电压80 kVp，管电流60~80 mAs，对比剂剂量1.2 ml/kg体质量；B组管电压70 kVp，管电流70~100 mAs，对比剂剂量1.0 ml/kg体质量；2组螺距均为3.4。测量2组图像肺动脉主干、肺静脉、左右心房CT值和噪声，计算SNR和肺动静脉CT值比值及有效辐射剂量（ED）；对图像质量进行主观评分；与术后所见进行对照。结果 最终入组58例，A组28例，B组30例。2组间各测量部位CT值、图像噪声、SNR及肺动静脉CT值比值差异均无统计学意义（P均> 0.05）；B组ED低于A组（P=0.013）。在显示细小肺静脉分支及引流血管方面，B组图像质量主观评分高于A组（P=0.047）。58例术后均诊断为APVC。在分型诊断方面，术前诊断准确率A组为96.43%（27/28），B组为93.33%（28/30）；对于合并畸形，术前诊断准确率A组为97.44%（38/39），B组95.35%（41/43），差异均无统计学意义（P均> 0.05）。结论 双源CT大螺距扫描结合低管电压技术术前诊断婴幼儿APVC准确率高，且可降低辐射剂量。 |
| 英文摘要: |
| Objective To explore the value of high-pitch combined with low tube voltage technique with dual-source CT in pre-operative diagnosis of infants with anomalous pulmonary venous connections (APVC). Methods Totally 60 infants with suspicious APVC under 3 years old were enrolled and underwent cardiac CTA examinations 1 week before surgical operation. The patients were randomly divided into group A and group B. In group A, CT scan parameters were 80 kVp, 60-80 mAs, and the contrast media of 1.2 ml/kg body weight, while in group B, the parameters were 70 kVp, 70-100 mAs, and the contrast media of 1.0 ml/kg. The pitch of the two groups was both 3.4. CT attenuation, image noises of pulmonary artery (PA), pulmonary vein (PV) and the dual-atrium cavity were measured, and SNR, the ratio of PA to PV (PA/PV) and the effective dose (ED) were quantified. Additionally, the subjective grading of image quality was scored. The results of CT diagnosis were compared with those of surgical operation. Results Finally, 58 patients were enrolled, with 28 in group A and 30 in group B. CT attenuation, image noises, SNR and PA/PV had no statistical difference between the two groups (all P>0.05). ED of group B was lower than that of group A (P=0.013). Group B had higher subjective image quality scores than group A in showing small branch vessels and their drainage vessels of pulmonary veins (P=0.047). All patients were diagnosed as APVC after surgery. The coincidence rate of classification diagnosis in group A was 96.43%(27/28), in group B was 93.33%(28/30). The coincidence rate of combined malformations in group A and B was 97.44% (38/39) and 95.35% (41/43), respectively. There was no statistical difference of coincidence rate between the 2 groups (both P > 0.05). Conclusion Dual-source CT high-pitch combined with low tube voltage technique has high diagnostic accuracy for infants with APVC, and can reduce radiation dose. |
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