能谱纯化技术在降低CT引导下肺肿瘤微波消融术中辐射剂量的应用研究

Clinical Value of Spectral Shaping Technology in Reducing the Radiation Dose of CT-guided Lung Tumor Microwave Ablation

目的探讨使用能谱纯化技术降低CT引导下肺肿瘤微波消融术(Microwave Ablation,MWA)中辐射剂量的可行性及其临床应用价值。方法连续纳入我院因诊断为肺部恶性肿瘤需行CT引导下肺肿瘤MWA的患者60名,并随机分为实验组(n=30,采用能谱纯化技术扫描,扫描电压为Sn100 kV,参考电流为96 mAs)和对照组(n=30,采用常规扫描技术,扫描电压为120 kV,参考电流为94 mAs)。其余扫描及重建参数相同。比较两组间主动脉CT值,图像噪声,信噪比(Signal to Noise Ratio,SNR),主观图像质量评分,医生操作时间以及两组患者所受的辐射剂量。结果60名患者均成功在CT引导下完成肺肿瘤MWA。实验组的图像噪声显著高于对照组[(13.80±1.71)分vs.(7.28±1.23)分,P<0.001],而SNR低于对照组[(2.02±0.32)分vs.(3.83±0.57)分,P<0.001]。两组间主动脉CT值、主观图像质量评分及操作时间均无统计学差异[(43.21±4.45分vs.45.56±5.86)分,P=0.605;(3.37±0.61分vs.3.68±0.58)分,P=0.194;(22.69±6.02)min vs.(21.93±4.63)min,P=0.687]。实验组患者所受的总辐射剂量为(0.89±0.44)mSv,显著低于对照组的(8.53±4.26)mSv,P<0.001。结论能谱纯化技术可以在保证图像质量和不增加操作时间的前提下,大幅降低CT引导下肺肿瘤MWA中患者所受的辐射剂量。

Objective To investigate the feasibility and clinical application value of spectrum purification technology to reduce the radiation dose in CT guided microwave ablation(MWA).Methods A total of 60 patients who were diagnosed as pulmonary malignant tumor and needed to undergo MWA guided by CT were selected and randomly divided into experimental group(n=30,scanning with energy spectrum purification technology,scanning voltage of sn100 kV,reference current of 96 mAs)and control group(n=30,using conventional scanning technology,scanning voltage was 120 kV,reference current was 94 mAs),while the other scanning and reconstruction parameters were the same.The aortic CT value,image noise,signal to noise ratio(SNR),subjective image quality score,doctor operation time and radiation dose received by the two groups were compared.Results All patients successfully completed MWA guided by CT.The image noise of the experimental group was significantly higher than that of the control group[(13.80±1.71)vs.(7.28±1.23),P<0.001],while the SNR was lower than that of the control group[(2.02±0.32)vs.(3.83±0.57),P<0.001].There was no significant difference in aortic CT value,subjective image quality score and operation time between the two groups[(43.21±4.45)vs.(45.56±5.86),P=0.605;(3.37±0.61)vs.(3.68±0.58),P=0.194;(22.69±6.02)min vs.(21.93±4.63)min,P=0.687].The total radiation dose of the experimental group was(0.89±0.44)mSv,which was significantly lower than that of the control group(8.53±4.26)mSv,P<0.001.Conclusion The use of energy spectrum purification technology can greatly reduce the radiation dose received by patients in lung tumor MWA under CT guidance while ensuring image quality and not increasing operating time.