腹部加压双期增强CT尿路造影技术在降低辐射剂量中的价值

摘要

目的 探讨腹部加压双期增强CT尿路造影(CTU)在降低受检者辐射剂量中的价值.方法 采用腹部加压方式对50例泌尿系统疾病患者行平扫和腹部加压双期增强CTU.对所有数据进行MPR、CPR等处理.记录每次扫描的容积剂量指数( CTDIvol)和剂量长度乘积(DLP),并计算有效剂量.回顾性分析50例经常规CTU检查患者的辐射剂量,并与腹部加压双期增强CTU结果进行对照.结果 接受腹部加压双期增强CTU的患者中,泌尿系统完整显示34例；16例因单侧或双侧输尿管显示不佳而接受延迟期追加扫描,其中7例通过延迟扫描完整显示双侧肾盂、输尿管及膀胱,4例患侧较静脉期显示有所改善,5例患侧肾盂对比剂稍增多,而输尿管、膀胱无显著变化.腹部加压双期增强CTU平均有效剂量为19.57 mSv,常规CTU的平均有效剂量为31.50 mSv,两者差异有统计学意义(P＜0.05).结论腹部加压双期增强CTU对尿路和病变显示效果较好,且辐射剂量明显降低.%Objective To explore the value of abdominal compression dual-phase enhanced CT urography (CTU) in reducing the radiation dose to subjects. Methods With abdominal compression, plain scan and abdominal compression dual-phase enhanced CTU were performed in 50 patients with urinary system diseases. MPR, CPR, etc were used in the postprocessing of all image data. CT dose index (CTDIvol) and dose length product (DLP) were recorded, and the effective dose was calculated. The radiation dose of other 50 patients underwent conventional CTU were analyzed retrospectively and compared with that of the dual phase enhance CTU. Results In 50 patients who underwent abdominal compression dual-phase enhanced CTU, urological system integrity was showed in 34 patients. Among the rest 16 patients who underwent added delayed scans for poorly displayed unilateral or bilateral ureters, bilateral renal pelvis, ureter and bladder were displayed clearly in 7, images were improved than those of venous phase in 4·contrast media dose slightly increased in 5 patients, while the displaying of ureter and bladder were not significantly improved. The average effective dose of abdominal compression dual-phase enhanced CTU was 19. 57 mSv, while of conventional CTU was 31. 50 mSv (P＜0. 05). Conclusion Abdominal pressure dual-phase enhanced CTU can improve the display of the urinary tract and lesions with flexible operation while reduce the radiation dose.