多层螺旋CT三低技术在肺动脉栓塞中的应用研究

Application of triple-low technique of multi-slice CT in pulmonary embolism

目的探讨多层螺旋CT(MSCT)三低技术在肺动脉栓塞中的应用效果。方法选取2020年12月至2021年12月萍乡市人民医院收治的80例怀疑肺动脉疾病且接受肺动脉检查螺旋CT血管成像患者作为研究对象,根据MSCT扫描方式分为常规组与三低组,每组40例。常规组行普通方案扫描,三低组行三低技术扫描,比较两组图像质量主观评价、图像质量客观评价[肺动脉CT值、信噪比(SNR)、对比噪声比(CNR)]、辐射剂量[剂量长度乘积(DLP)、有效剂量(ED)]、造影剂外渗率。结果两组图像评分均>3分,图像质量较好;两位阅片医师对两组图像质量的主观评分比较差异无统计学意义;两位医师评分结果一致性较好(Kappa=0.854)。三低组肺动脉干及左右肺动脉、左右各叶肺动脉CT值均高于常规组,差异有统计学意义(P<0.05);两组肺动脉干及左右肺动脉、左右各叶肺动脉SNR、CNR比较差异无统计学意义。三低组DLP小于常规组,ED少于常规组,差异有统计学意义(P<0.05)。三低组造影剂外渗率低于常规组,但差异无统计学意义。结论MSCT三低技术在临床肺动脉栓塞检查中具有一定的应用价值,其图像质量满意,且能减少对比剂用量、辐射剂量,降低造影剂外渗率。

Objective To investigate the application effect of triple-low technique of multi-slice spiral CT(MSCT)in pulmonary embolism.Methods A total of 80 patients with suspected pulmonary artery diseases who received spiral CT angiography admitted to Pingxiang People's Hospital from December 2020 to December 2021 were selected as the study subjects,and they were divided into the conventional group and the triple-low group according to the MSCT scanning method,with 40 cases in each group.The conventional group was scanned with conventional scheme,while the triple-low group received was scanned with triple-low technique,the subjective evaluation of image quality,objective evaluation of image quality(pulmonary artery CT value,signal noise ratio[SNR]and contrast noise ratio[CNR]),radiation dose(dose length product[DLP]and effective dose[ED]),and contrast agent extravasation rate were compared between the two groups.Results The image scores of the two groups were>3 scores,and the image quality was good;there was no statistically significant difference in the subjective scores of image quality obtained by two radiologists between the two groups;the consistency between the scores obtained by two radiologists was good(Kappa=0.854).CT values of the pulmonary trunk,left and right pulmonary arteries,left and right lobar pulmonary arteries in the triple-low group were higher than those in the conventional group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in SNR and CNR of pulmonary trunk,left and right pulmonary arteries,left and right lobar pulmonary arteries between the two groups.The DLP in the triple-low group was smaller than that in the conventional group,and ED in the triple-low group were lower than those in the conventional group,and the differences were statistically significant(P<0.05).The contrast agent extravasation rate in the triple-low group was lower than that in the conventional group,but the difference was not statistically significant.Conclusion The triple-low technique in MSCT has certain application value in clinical examination of pulmonary embolism,with satisfactory image quality,and it can reduce the dosage of contrast agent,radiation dose and contrast agent extravasation rate.