Wirth Stefan, Körner Markus, Treitl Marcus, Linsenmaier Ulrich, Leidel Bernd A, Jaschkowitz Thomas, Reiser Maximilian F, Kanz Karl G
Department of Clinical Radiology, University Hospital of Munich, Nussbaumstrasse 20, 80336, Munich, Germany.
Eur Radiol. 2009 Aug;19(8):1857-66. doi: 10.1007/s00330-009-1359-9. Epub 2009 Mar 4.
The purpose of the study was to evaluate both CT image quality in a phantom study and feasibility in an initial case series using automated chest compression (A-CC) devices for cardiopulmonary resuscitation (CPR). Multidetector CT (MDCT) of a chest/heart phantom (Thorax-CCI, QRM, Germany) was performed with identical protocols of the phantom alone (S), the phantom together with two different A-CC devices (A: AutoPulse, Zoll, Germany; L: LUCAS, Jolife, Sweden), and the phantom with a LUCAS baseplate, but without the compression unit (L-bp). Nine radiologists evaluated image noise quantitatively (n = 244 regions, Student's t-test) and also rated image quality subjectively (1-excellent to 6-inadequate, Mann-Whitney U-test). Additionally, three patients during prolonged CPR underwent CT with A-CC devices. Mean image noise of S was increased by 1.21 using L-bp, by 3.62 using A, and by 5.94 using L (p < 0.01 each). Image quality was identical using S and L-bp (1.64 each), slightly worse with A (1.83), and significantly worse with L (2.97, p < 0.001). In all patient cases the main lesions were identified, which led to clinical key decisions. Image quality was excellent with L-bp and good with A. Under CPR conditions initial cases indicate that MDCT diagnostics supports either focused treatment or the decision to terminate efforts.
本研究的目的是在体模研究中评估CT图像质量，并在初始病例系列中评估使用自动胸外按压（A-CC）设备进行心肺复苏（CPR）的可行性。使用相同的方案对胸部/心脏体模（Thorax-CCI，德国QRM公司）进行多排CT（MDCT）检查，分别为单独的体模（S）、体模与两种不同的A-CC设备一起（A：德国Zoll公司的AutoPulse；L：瑞典Jolife公司的LUCAS），以及带有LUCAS底板但无按压单元的体模（L-bp）。九名放射科医生对图像噪声进行定量评估（n = 244个区域，采用学生t检验），并对图像质量进行主观评分（1-优秀至6-不足，采用曼-惠特尼U检验）。此外，三名在长时间CPR期间的患者使用A-CC设备进行了CT检查。与S相比，使用L-bp时平均图像噪声增加1.21，使用A时增加3.62，使用L时增加5.94（均p < 0.01）。使用S和L-bp时图像质量相同（均为1.64），使用A时稍差（1.83），使用L时明显更差（2.97，p < 0.001）。在所有患者病例中均识别出主要病变，这些病变导致了临床关键决策。使用L-bp时图像质量优秀，使用A时良好。在CPR条件下，初始病例表明MDCT诊断有助于聚焦治疗或做出终止抢救的决定。
