Wang Meng, Zheng Chao, Yang Lin, Su Juan, Sheng Jiexin, He Xiaolong, Wang Bo, Wu GuangHang
Department of Radiology, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China.
Department of Cardiac and Vascular Surgery, Hanzhong Central Hospital, Hanzhong City, Shannxi Province, China.
BMC Med Imaging. 2025 May 30;25(1):198. doi: 10.1186/s12880-025-01742-w.
Although one-stop cerebral carotid aortic CTA is useful for diagnosing and treating type A aortic dissection, the radiation dose is increased due to the wider scanning range. The impact of varying arm positions on radiation dose and image quality is unknown when optimizing the scan protocol. This study aims to determine the best scanning protocol to minimize radiation dose while maintaining image quality, as well as how arm position impacts radiation dose and image quality of low dose one-stop cerebral carotid aortic CTA.
Between January 2022 and August 2023,a total of 185 patients were enrolled in the study and underwent low-dose one-stop cerebral carotid aortic CTA. Two groups were randomly assigned to the patients: Rising arm group (group A) and drooping arm group (group B). Two radiologists assessed the subjective image quality using a 5-point scale, and kappa test was performed to evaluate the consistency between observers. Regions of interest (ROI) were set up in target vessels, and the objective image quality was evaluated by attenuation, noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR). Tube current, volumetric CT dose index (CTDIvol) and dose length product (DLP) and the effective radiation dose (E) were compared between the two groups. The comparison was performed using t test.
Subjective image quality of group B was significantly higher than group A (p < 0.05), and the patient characteristics of the two groups did not differ significantly (P > 0.05). The consistency between observers (κ = 0.84 for group A and κ = 0.89 for group B) were excellent. Group B showed lower overall noise level, higher SNR, CNR, and higher vascular attenuation level than group A. Furthermore, group B showed reduced DLP, E, tube current, and CTDIvol, and higher aortic noise and decreased cerebral and carotid vascular noise (all p < 0.05).
Low-dose dual-source one-stop cerebral carotid aortic CTA radiation dose can be minimized and image quality can be improved by positioning both arms on the body side.
Not applicable.
尽管一站式脑颈动脉主动脉CT血管造影（CTA）对A型主动脉夹层的诊断和治疗很有用，但由于扫描范围更广，辐射剂量会增加。在优化扫描方案时，不同手臂位置对辐射剂量和图像质量的影响尚不清楚。本研究旨在确定在保持图像质量的同时使辐射剂量最小化的最佳扫描方案，以及手臂位置如何影响低剂量一站式脑颈动脉主动脉CTA的辐射剂量和图像质量。
在2022年1月至2023年8月期间，共有185例患者纳入本研究并接受低剂量一站式脑颈动脉主动脉CTA检查。将患者随机分为两组：手臂上举组（A组）和手臂下垂组（B组）。两名放射科医生使用5分制评估主观图像质量，并进行kappa检验以评估观察者之间的一致性。在目标血管中设置感兴趣区（ROI），并通过衰减、噪声、信噪比（SNR）和对比噪声比（CNR）评估客观图像质量。比较两组之间的管电流、容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）和有效辐射剂量（E）。采用t检验进行比较。
B组的主观图像质量显著高于A组（p < 0.05），两组患者特征无显著差异（P > 0.05）。观察者之间的一致性良好（A组κ = 0.84，B组κ = 0.89）。B组的总体噪声水平低于A组，SNR、CNR更高，血管衰减水平更高。此外，B组的DLP、E、管电流和CTDIvol降低，主动脉噪声增加，脑和颈动脉血管噪声降低（均p < 0.05）。
通过将双臂置于身体两侧，可以使低剂量双源一站式脑颈动脉主动脉CTA的辐射剂量最小化并提高图像质量。
不适用。
