基于体质量指数调节管电流个性化成人胸部低剂量CT扫描方案的应用研究

An applied study of a personalized adult chest low-dose CT scanning protocol based on body mass index-adjusted tube current

目的:探讨基于体质量指数(BMI)调节管电流个性化成人胸部低剂量CT扫描方案的应用效果。方法:选取2023年1月—2023年12月成人胸部CT检查患者160例,根据随机数字表法分为常规剂量组和低剂量组,每组80例。记录两组患者的性别、年龄,测量患者身高、体质量并计算BMI。常规剂量组设置管电压110 kV、固定管电流150 mA。低剂量组设置管电压110 kV,根据患者BMI设置管电流(高BMI组:BMI>24 kg/m^(2),管电流50 mA;中BMI组:19 kg/m^(2)≤BMI≤24 kg/m^(2),管电流40 mA;低BMI组:BMI<19 kg/m^(2),管电流30 mA),由2名放射科中级职称以上医师负责对胸部CT图像质量进行评价。采用统计学分析软件对患者一般资料、图像质量评价结果、辐射剂量数据进行统计学分析。结果:两组患者的性别、年龄、体质量、身高、BMI比较,差异均无统计学意义(P>0.05)。低剂量组图像主观评价5分占比低于常规剂量组,3分占比高于常规剂量组,差异有统计学意义(P<0.05);低剂量组图像主观评价4分占比与常规剂量相近,差异无统计学意义(P>0.05)。低剂量组信噪比(SNR)、噪声比(CNR)均高于常规剂量组,差异有统计学意义(P<0.05)。低剂量组虽然显著降低管电流,增加图像SNR和CNR,但低剂量组患者主观图像质量评分在3分以上,图像质量能满足疾病诊断要求。低剂量组患者的CT剂量指数(CT DIvo)、剂量长度乘积(DLP)、有效剂量(ED)均低于常规剂量组,差异有统计学意义(P<0.05)。结论:基于患者BMI调节管电流个性化成人胸部低剂量CT扫描方案,图像质量可满足临床诊断要求,有效降低辐射剂量,减少潜在辐射风险。

Objective:To explore the application effect of personalized low-dose CT scanning scheme for adult chest based on body mass index(BMI)regulation tube current.Methods:A total of 160 adult patients who underwent chest CT examination in hospital from January 2023 to December 2023 were selected as the study subjects.They were randomly divided into a conventional dose group and a low-dose group using a random number table method,with 80 cases in each group.Record the gender and age of two groups of patients,measure their height and weight,and calculate their BMI.The conventional dose group is set with a tube voltage of 110 kV and a fixed tube current of 150 mA.The low-dose group was set with a tube voltage of 110 kV,and the tube current was set based on the patient's BMI(high body mass index group:BMI>24 kg/m^(2),tube current 50 mA;medium body mass index group:19 kg/m^(2)≤BMI≤24 kg/m^(2),tube current 40 mA;low body mass index group:BMI<19 kg/m^(2),tube current 30 mA).Two radiologists with intermediate professional titles or above were responsible for evaluating the quality of chest CT images.The patients'general data,image quality evaluation results and radiation dose data were analyzed statistically.Results:There was no statistically significant difference(P>0.05)in the clinical data of gender,age,weight,height,and BMI between the two groups of patients.The subjective evaluation of images in the low-dose group had a 5-point lower proportion than that in the conventional dose group,and a 3-point higher proportion than that in the conventional dose group,with a statistically significant difference(P<0.05).The proportion of subjective evaluation scores for low-dose group images was similar to that of conventional dose,and the difference was not statistically significant(P>0.05).The Signal-to-noise ratio(SNR)and contrast to noise ratio(CNR)values of the low-dose group were higher than those of the conventional dose group,and the difference was statistically significant(P<0.05).Although the low-dose group significantly reduces tube current and increases image SNR and CNR,the subjective image quality score of patients in the low-dose group is above 3 points,and the image quality can meet the requirements of disease diagnosis.The CTdoseindex(CTDIvo),dose-length product(DLP),and effective dose(ED)values of patients in the low-dose group were lower than those in the conventional dose group,and the differences were statistically significant(P<0.05).Conclusion:The personalized low-dose CT scan plan for adult chest based on patient BMI regulation tube current can meet clinical diagnostic requirements in terms of image quality,effectively reduce radiation dose and potential radiation risk.