Spiral CT scanning of upper airway in OSAHS with low-dose
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摘要: 目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)上气道螺旋CT低剂量扫描的临床价值。 方法 将120例OSAHS患者采用简单随机法均分为实验组和对照组,2组均行上气道平静呼吸、深吸气末、深呼气末、闭口堵鼻深吸气四个呼吸时相扫描。实验组管电流使用低剂量50 mA,对照组常规剂量360 mA。记录2种剂量的容积CT剂量指数(CTDIvol)、剂量长度积(DLP)和有效剂量(effective dose,E)值。在舌体相同位置进行感兴趣区(region of interest,ROI) CT值测量,并记录每组剂量下CT值和标准差(SD)。双盲法主观评价各组图像质量并给予优、良、差分级,相关数据行统计学处理。 结果 实验组和对照组扫描长度差异无统计学意义(t=7.23,P=0.479),DLP、E值的比较差异有统计学意义(t=108.252,P=0.000),CTDIvol、DLP、E值实验组比对照组降低87.5%。信噪比的比较,实验组SNR值为6.31±1.75,对照组SNR值为10.17±3.13,t=3.19,P=0.006,实验组SNR明显降低。实验组SD值为25.74±2.61,对照组SD值为1.70±0.17,2组噪声比较,实验组噪声明显增大(t=29.022,P<0.001)。主观评判对照组图像质量以优为主,实验组图像质量以良为主,仅3例为差级图像,故基本不影响测量和诊断。 结论 OSAHS上气道50 mA低剂量CT扫描能够大幅度降低辐射剂量,且不影响上气道的测量与诊断,具有实际临床应用价值。Abstract: Objective To explore the clinical value of the upper airway low-dose spiral CT applied in the obstructive sleep apnea and hypopnea syndrome(obstructive sleep apnea hypopnea syndrome,OSAHS). Methods One hundred and twenty patients OSAHS were divided equally into the experimental group and the control group.All patients were underwent the upper airway low-dose spiral CT scanning during the four different states of breathing,calm,the end of deep inspiration and deep expiration,inspiration closed mouth and nose.The tube current of the experimental group used low-dose was 50 mA,the control group used the regular dose was 360 mA.The values of the volumetric CT dose index(CTDIvol),dose length product(DLP) and the effective dose (effective dosed,E) for each case were respectively recorded.The CT value of ROI in each case was measured on the same tongue position,and the Standard Deviation(SD) of CT value and the Standard Deviation (SD) of CT value was also recorded.The double-blind method was used to subjectively evaluate the image quality,and overall image quality was assessed using a 3 grading scale(excellent,good,poor),then,statistical analysis was done with related data. Results There was no significant difference in length of scanning between the experimental group and the control group,compared to control group,significant differencens in DLP and E value were observed(t=108.252,P<0.001) and CTDIvol,DLP,E value in experimental group decreased by 87.5%.Signal-Noise Ratio decreased significantly in experimental group(SNR value 6.31±1.75 vs. 10.17±3.13 respectively,t=3.19,P=0.006).Compared to control group,noise increased significantly in experimental group(SD value 25.74±2.61 vs. 1.70±0.17 respectively,t=29.022,P<0.001).Subjective evaluation of image quality with control group was mainly excellent,and mainly good with experimental group,only three cases were of poor-grade,but it did not influence the measurements and diagnostics. Conclusion Scanning of upper airway in OSAHS with 50 mA low-dose can reduce radiation dose significantly,dose not affect the measurement and diagnosis of airway,and has practical value clinically.
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Key words:
- Upper airway /
- Radiation dose /
- Tomography
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