Department of Radiology, University College Cork and Cork University Hospital, Wilton, Cork 1111, Ireland.
Radiology. 2010 Dec;257(3):820-9. doi: 10.1148/radiol.10100278. Epub 2010 Sep 27.
To develop low-dose thin-section computed tomographic (CT) protocols for assessment of cystic fibrosis (CF) in pediatric patients and determine the clinical usefulness thereof compared with chest radiography.
After institutional review board approval and informed consent from patients or guardians were obtained, 14 patients with CF and 11 patients without CF (16 male, nine female; mean age, 12.6 years ± 5.4 [standard deviation]; range, 3.5-25 years) who underwent imaging for clinical reasons underwent low-dose thin-section CT. Sections 1 mm thick (protocol A) were used in 10 patients, and sections 0.5 mm thick (protocol B) were used in 15 patients at six levels at 120 kVp and 30-50 mA. Image quality and diagnostic acceptability were scored qualitatively and quantitatively by two radiologists who also quantified disease severity at thin-section CT and chest radiography. Effective doses were calculated by using a CT dosimetry calculator.
Low-dose thin-section CT was performed with mean effective doses of 0.19 mSv ± 0.03 for protocol A and 0.14 mSv ± 0.04 for protocol B (P < .005). Diagnostic acceptability and depiction of bronchovascular structures at lung window settings were graded as almost excellent for both protocols, but protocol B was inferior to protocol A for mediastinal assessment (P < .02). Patients with CF had moderate lung disease with a mean Bhalla score of 9.2 ± 5.3 (range, 0-19), compared with that of patients without CF (1.1 ± 1.4; P < .001). There was excellent correlation between thin-section CT and chest radiography (r = 0.88-0.92; P < .001).
Low-dose thin-section CT can be performed at lower effective doses than can standard CT, approaching those of chest radiography. Low-dose thin-section CT could be appropriate for evaluating bronchiectasis in pediatric patients, yielding appropriate information about lung parenchyma and bronchovascular structures.
为评估儿科囊性纤维化（CF）患者开发低剂量薄层 CT 方案，并确定与胸部 X 线摄影相比其临床应用价值。
本研究经机构审查委员会批准，并获得患者或监护人的知情同意后，对 14 例 CF 患者和 11 例非 CF 患者（16 例男性，9 例女性；平均年龄 12.6 岁±5.4[标准差]；年龄范围 3.5-25 岁）进行了临床成像检查。10 例患者使用 1 毫米厚的切片（方案 A），15 例患者使用 0.5 毫米厚的切片（方案 B），在 120 kVp 和 30-50 mA 下于 6 个层面进行扫描。两名放射科医生对图像质量和诊断可接受性进行了定性和定量评分，并在薄层 CT 和胸部 X 线摄影中对疾病严重程度进行了定量评估。使用 CT 剂量计算器计算有效剂量。
方案 A 的平均有效剂量为 0.19 mSv±0.03，方案 B 的平均有效剂量为 0.14 mSv±0.04（P<.005）。两种方案的肺窗设置下支气管血管结构的诊断可接受性和显示均被评为几乎优秀，但方案 B 在纵隔评估方面逊于方案 A（P<.02）。CF 患者的肺部疾病处于中度水平，平均 Bhalla 评分为 9.2±5.3（范围 0-19），而非 CF 患者的评分为 1.1±1.4（P<.001）。薄层 CT 与胸部 X 线摄影之间具有极好的相关性（r=0.88-0.92；P<.001）。
与标准 CT 相比，低剂量薄层 CT 可在更低的有效剂量下进行，接近胸部 X 线摄影的剂量。低剂量薄层 CT 可能适合评估儿科患者的支气管扩张症，提供关于肺实质和支气管血管结构的适当信息。
