防散射滤线栅对床旁CR与DR胸部摄片图像质量的影响研究

Study of the Effect of Antiscatter Grids on the Image Quality of Bedside CR and DR Chest Radiographs

目的探讨在床旁CR与DR胸部摄片中有无采用防散射滤线栅对图像质量的影响。方法选取2020年1~12月在苏州市第九人民医院住院并接受床旁胸部正位X线摄片的245例患者,使用4种不同摄片方式获得图像,由2名放射科主治医师和2名放射科副主任医师采用9分可见度等级量表单独评估图像质量。组内相关系数(ICC)用于评估图像质量标准的观察者间一致性。通过方差分析对评分进行比较,在多组比较的情况下,进行事后检验法Tukey检验;在单组比较的情况下,对得分进行t检验。结果有滤线栅的床旁DR胸部摄片优于无滤线栅(P<0.001);对于肺实质和软组织的划分以及整体图像质量的评估,有滤线栅的床旁CR胸部摄片优于无滤线栅(P<0.001),在异物可见度的评估中,有滤线栅的床旁CR胸部摄片不及无滤线栅(P<0.001),对于胸椎的划分,有滤线栅的床旁CR胸部摄片的优越性也不明显(P=0.554);不论有无滤线栅,床旁DR胸部摄片在整体图像质量、肺实质可见度、软组织可见度、胸椎可见度和异物可见度方面均优于床旁CR胸部摄片;无论评估的结构或使用的摄片方式,以及使用或不使用滤线栅,观察者间一致性均具有统计学意义(P<0.05)。结论床旁DR胸部摄片在各项图像质量可见度中均优于床旁CR,防散射滤线栅明显改善了床旁DR胸部摄片的图像质量,但在床旁CR胸部摄片中只改善了肺实质和软组织的划分以及整体图像质量。

Objective To investigate the effect of antiscatter grids on image quality in bedside CR and DR chest radiography.Methods 245 patients who were hospitalized in the Suzhou Ninth People’s Hospital and received the bedside chest radiographs were selected from January 2020 to December 2020.The images were obtained by four different methods of taking pictures.The quality of images was evaluated by 2 attending radiologists and 2 deputy chief radiologists by 9-point visibility scale.The intraclass correlation coefficient(ICC)was used to assess interobserver agreement on image quality standards.Scores were compared by ANOVA with a post hoc test,Tukey’s test,in the case of multiple group comparisons and a t-test for scores in the case of single group comparisons.Results Bedside DR chest radiographs with antiscatter grids were superior to those without(P<0.001);for the delineation of lung parenchyma and soft tissue and for the assessment of overall image quality,bedside CR chest radiographs with antiscatter grids were superior to those without(P<0.001),for the assessment of foreign body visibility,bedside CR chest radiographs with antiscatter grids were inferior to those without(P<0.001),and for the division of thoracic vertebra,the superiority of bedside CR chest radiography with filter grating was not obvious(P=0.554);bedside DR chest cinematography with or without the antiscatter grids was superior to bedside CR chest cinematography in terms of overall image quality,lung parenchymal visibility,soft tissue visibility,thoracic spine visibility,and foreign body visibility;interobserver agreement was statistically significant regardless of the structure of the assessment or the imaging modality used,with or without the antiscatter grids.The interobserver agreement was statistically significant(P<0.05),regardless of the structure assessed or the imaging method used,with or without the use of antiscatter grids.Conclusion Bedside DR chest radiography was superior to bedside CR in all image quality visibility,and the antiscatter significantly improved image quality in bedside DR chest radiography,but only improved the delineation of lung parenchyma and soft tissue and overall image quality in bedside CR chest radiography.