Embleton K V, Nicholson D A, Hufton A P, Jackson A
Imaging Science and Biomedical Engineering, University of Manchester, Manchester, UK.
Clin Radiol. 2003 Dec;58(12):955-63. doi: 10.1016/s0009-9260(03)00297-6.
To determine the optimal collimation, pitch, tube current and reconstruction interval for multi-slice computed tomography (CT) colonography with regard to attaining satisfactory image quality while minimizing patient radiation dose.
Multi-slice CT was performed on plastic, excised pig colon and whole pig phantoms to determine optimal settings. Performance was judged by detection of simulated polyps and statistical measures of the image parameters. Fat and muscle conspicuity was measured from images of dual tube-current prone/supine patient data to derive a measure of tube current effects on tissue contrast.
A collimation of 4 x 2.5 mm was sufficient for detection of polyps 4 mm and larger, provided that a reconstruction interval of 1.25 mm was used. A pitch of 1.5 allowed faster scanning and reduced radiation dose without resulting in a loss of important information, i.e. detection of small polyps, when compared with a pitch of 0.75. Tube current and proportional radiation dose could be lowered substantially without deleterious effects on the detection of the air-mucosal interface, however, increased image noise substantially reduced conspicuity of different tissues.
An optimal image acquisition set-up of 4 x 2.5 mm collimation, reconstruction interval of 1.25 mm, pitch of 1.5 and dual prone/supine scan of 40/100 mA tube current is proposed for our institution for scanning symptomatic patients. Indications are that where CT colonography is used for colonic polyp screening in non-symptomatic patients, a 40 mA tube current could prove satisfactory for both scans.
确定多层螺旋计算机断层扫描(CT)结肠成像的最佳准直、螺距、管电流和重建间隔,以在使患者辐射剂量最小化的同时获得令人满意的图像质量。
对塑料、切除的猪结肠和整个猪模型进行多层CT扫描以确定最佳设置。通过检测模拟息肉和图像参数的统计测量来判断性能。从双管电流俯卧/仰卧位患者数据的图像中测量脂肪和肌肉的清晰度,以得出管电流对组织对比度影响的测量值。
4×2.5mm的准直对于检测4mm及更大的息肉是足够的,前提是使用1.25mm的重建间隔。与0.75的螺距相比,1.5的螺距允许更快的扫描并降低辐射剂量,而不会导致重要信息丢失,即小息肉的检测。管电流和比例辐射剂量可以大幅降低,而不会对气-黏膜界面的检测产生有害影响,然而,图像噪声增加会显著降低不同组织的清晰度。
建议我们机构对有症状的患者进行扫描时采用4×2.5mm准直、1.25mm重建间隔、1.5螺距和40/100mA管电流的双俯卧/仰卧位扫描的最佳图像采集设置。有迹象表明,在对无症状患者进行CT结肠成像结肠息肉筛查时,40mA管电流对两次扫描可能都令人满意。