低剂量低对比剂低张胃充气造影MSCT诊断胃肿瘤的临床研究

摘要

目的：探讨低剂量低对比剂低张胃充气造影多层螺旋CT (MSCT)诊断胃肿瘤的临床应用价值。方法选取2015年1月至2016年1月在我院进行胃镜检查拟患有胃肿瘤的患者90例，所有患者均进行MSCT检查，将患者按就医顺序随机分为三组，每组30例。对照组采用固定毫安的方式进行检查，实验组使用低剂量低对比剂低张胃充气的方式进行检查，观察组同样使用该方法但在噪声指数中标准差方面有所不同，其中实验组SD为12，观察组为15，造影剂均使用碘海醇。对三组患者的MSCT图像质量和剂量加权指数降低率进行比较。结果对照组与实验组在胃壁情况、脏器间情况及脏器显示方面图像均较为清晰，而观察组在胃壁情况、脏器间情况及脏器显示方面，图像质量均相对较差，但并未影响定性诊断；对照组与实验组图像质量评分为10分的比例比较，差异无统计学意义(P>0.05)，二者与观察组相比较，差异具有统计学意义(P<0.05)；三组剂量加权指数降低率分别为12.7%、35.7%、78.6%，组间比较，差异均具有统计学意义(P<0.05)。结论在不影响图像质量的情况下，尽量减少对比剂及使用智能毫安调节的方式进行MSCT能减少人体受到的辐射量，提高安全性，同时有效减少患者的经济负担。低剂量低对比剂低张胃充气可有效提高胃肿瘤的MSCT诊断效果，具有重要的临床推广价值。%Objective To explore the clinical application value of low-dose multi-slice spiral CT (MSCT) with low contrast agent and low inflated stomach in the diagnosis of gastric cancer. Methods Ninety patients with gastric cancer who underwent gastroscopy in our hospital from January 2015 to January 2016 were selected. All patients were performed MSCT examination, and the patients were randomly divided into 3 groups (control group, experimental group, observation group) according to the order of medical treatment, with 30 patients in each group. Control group was examined by the way of fixed milliampere (mA). The experimental group was examined by the way of low dose and low contrast agent and low inflated stomach, and the observation group applied the same method but with different standard deviation (SD) in noise index (SD=12 for experimental group and SD=15 for observation group). Iohexol was used as the contrast agent. The MSCT image quality and decreased rate of dose-weighted index were compared between the three groups. Results The image quality of stomach, organ surroundings and organs in control group and the experi-mental group was relatively clear, while the quality of the images in the observation group was relatively poor, which did not affect the qualitative diagnosis. The proportions of images scored 10 in the control group and the experimental group had no significant difference (P>0.05), but they showed statistically significant difference with that in the obser-vation group (P<0.05). The decreased rate of dose-weighted index in the control group, experimental group, observa-tion group were 12.7%, 35.7%, 78.6%, respectively, with statistically significant differences among the three groups (P<0.05). Conclusion On the premise of not affecting the quality of the image, to reduce the contrast agent as far as possible and to use intelligent mA regulation in MSCT can reduce the radiation, improve the safety, and effectively de-crease the economic burden of patients. Low-dose multi-slice spiral CT with low contrast agent and low inflated stomach can effectively improve the MSCT diagnosis of gastric cancer, which has important clinical value.