超大螺距Turbo Flash扫描模式在学龄前儿童胸部检查中不用镇静剂的可行性

摘要

目的 探讨超大螺距Turbo Flash扫描模式在学龄前儿童胸部检查中不用镇静剂的可行性.方法 将90例胸部CT检查前评估心理状态为紧张或恐惧的学龄前患儿按扫描时间先后分为3组,每组30例.A组患儿应用镇静剂后行常规CT扫描,开启CARE Dose 4D/CARE kV扫描模式,螺距为1.9;B组患儿应用镇静剂后行超大螺距Turbo Flash模式扫描,螺距为3.0;C组患儿不予镇静剂干预,行超大螺距Turbo Flash模式扫描.比较3组间的扫描时间、辐射剂量、图像质量及诊断效能.结果 3组间主动脉根部、脊柱后方肌肉及皮下脂肪的CT值、主动脉根部噪声、SNR、CNR差异均无统计学意义(P均＞0.05),肺窗、纵隔窗图像质量主观评分差异均无统计学意义(P均＞0.05).A组的扫描时间及辐射剂量[容积CT剂量指数(CTDIvo1)、剂量长度乘积(DLP)、有效剂量(ED)]均高于B组及C组(P均＜0.05),B组与C组间扫描时间及辐射剂量(CTDIvol、DLP、ED)差异均无统计学意义(P均＞0.05).3组中,CT诊断与临床最终诊断结果间差异均无统计学意义(P均＞0.05).结论 超大螺距Turbo Flash模式扫描可缩短扫描时间、降低辐射剂量.对心理状态为紧张或恐惧的学龄前儿童检查时,可在避免使用镇静剂的同时获得满意的图像质量.%Objective To investigate the feasibility of chest examination using ultra-large pitch Turbo Flash in Force CT in preschool children without sedative.Methods A total of 90 preschool children evaluated as nervous or frightened were equally divided into 3 groups according to the scanning time.For group A,the routine scan with the mode of CARE Dose 4D/CARE kV was performed,and the sedative was used.For group B,the scan with ultra-large pitch Turbo Flash model and pitch as 3.0 was performed,and the sedative was used.For group C,the same scan mode as group B was performed but without sedative.The scanning time,radiation dose,image quality and the diagnostic efficiency were compared among 3 groups.Results There were no significant differences of the CT values of the aorta root,spinal posterior muscles and subcutaneous fat,the noise of the aorta root,SNR and CNR among 3 groups (all P＞0.05).Moreover,no significant differences of the subjective score of image quality in pulmonary window and mediastinum window images were found among 3 groups (both P＞0.05).The scanning time and radiation dose indexes (CT dose index volume [CTDIvo1],doselength product [DLP],effective dose [ED]) of group A were significantly higher than those of group B and group C (all P ＜0.05),while there were no significant differences between group B and group C (all P＞0.05).There were no significant differences between the CT diagnosis and clinical diagnosis results in all 3 groups (all P＞0.05).Conclusion It can shorten the scanning time and decrease the radiation dose by using the mode of ultra-large pitch Turbo Flash.And the satisfactory image quality can be obtained without sedative for nervous or frightened preschool children.