数字化导管定位X线图像的视觉分级分析:双能量减影和导管类型对图像质量的影响

Visual Grading Analysis of Digital Catheter Positioning X-ray Images:Impact of DualEnergy Subtraction and Catheter Type on Image Quality

目的研究比较数字化X线(DR)和双能量减影技术(DES)对植入式导管定位摄影的图像质量和对患者的相关辐射水平。方法利用可视化视觉分级分析(VGA)研究方法对我院69例进行DR和DES两种摄影技术的患者图像质量进行评估,其结果进行Wilcoxon符号秩检验后比较DR与DES在不同导管类型间图像质量的差异。辐射剂量采用设备显示单次曝光剂量和剂量面积乘积(DAP)参考值分析患者接受的额外剂量水平。结果5位观察者对DR与DES的VGAS结果比较,P<0.0001。DES与DR导管定位图像在不同导管类型分组之间的P<0.001。观察者内部变异性进行Friedman检验,P值(0.11~0.89),Friedman统计值(1.16~8.54),内部观察性一致。PICC、输液港和腹部透析管三种导管类型的DES与DR单次曝光剂量和DAP结果比较,P>0.05,输尿管组的结果显示P<0.05。DES较DR在PICC组、输液港组和腹部透析管组剂量增加3%~17%,输尿管组剂量降低22%~23%。结论这项VGA研究表明,植入体内的导管定位X线图像中DES与DR存在明显差异,尤其是对于背景结构混淆的病例,DES可帮助快速辅助诊断。VGA研究方法对于放射实践中优化研究的设置简便且直观,推荐放射技师利用这种对图像质量的详细评估结果来优化研究影响图像质量技术定义的方法。

Objective Study compares the image quality of digital X-ray(DR)and dual-energy subtraction technology(DES)for positioning imaging of implantable catheters and related radiation levels to patients.Methods The image quality of 69 patients who underwent DR and DES photography techniques in our hospital was evaluated using visual grading analysis(VGA)research method,the results were compared with Wilcoxon signed rank test to compare the statistical quality of DR and DES between different catheter types.Radiation dose is based on the single exposure dose and the dose area product(DAP)reference value by the device to evaluate the additional dose level received by the patient.Results Comparison of VGAS results of DR and DES by 5 observers,P<0.0001.DES and DR catheter positioning images between different catheter type groups,P<0.001.The internal variability of observers was evaluated by Friedman test,P value(0.11~0.89),Friedman statistic value(1.16~8.54),internal observations were consistent.Comparison of single exposure dose and DAP results of DES and DR of three catheter types of PICC,venous port aces(VPA)and peritoneal dialysis catheter(PDC),P>0.05,the results of double-pigtail stents(DPS)group showed P<0.05.Compared with DR,the dose of DES in PICC group,VPA group and PDC group increased by 3%to 17%,and the dose of DPS group decreased by 22%to 23%.Conclusion This VGA study shows that there is a clear difference between DES and DR in catheter positioning X-ray images,especially for cases with confusing background structure,DES can help quickly diagnose.The VGA research method is simple and intuitive for setting up optimization studies in radiology practice.It is recommended that radiologists use this detailed assessment of image quality to optimize research methods that affect the definition of image quality technology.