目的:探讨颌骨低剂量多层螺旋CT(muti-slice computed tomography, MSCT)成像技术在口腔种植定位术前评估中的临床价值。方法:将80例口腔种植术前的患者随机分为4组,每组20例,使用SIEMENS Definition AS40 CT机,在其他扫描参数相同的情况下分别采用60 mA、50 mA、40 mA的管电流进行颌骨MSCT扫描,并与常规管电流90 mA组(20例)进行对比,记录4组不同毫安的容积CT剂量指数(volume computed tomography dose index, CTDIv)和放射线剂量长度乘积(dose length product,DLP),分析比较4组间的CTDIv、DLP及图像质量。结果:40 mA、50 mA、60 mA、90 mA 4组间比较,CTDIv、DLP存在差异(P<0.05),而将4组进行两两组间比较,则除了60 mA组与90 mA组间的CTDIv、DLP差异无统计学意义(P>0.05)外,其余任意2组间的CTDIv、DLP差异均存在统计学意义(P<0.05)。4组间的图像质量差异无统计学意义(P>0.05)。结论:采用40 mA低剂量MSCT扫描既能保证图像质量,又能满足临床术前诊断的需求,并可大幅度(35.0%)降低患者所受辐射剂量。
Objective: To investigate the value of low dose muti-slice computed tomography (MSCT) in preoperative evaluation of location for oral implantation procedure. Methods: A total of 80 patients planned to receive oral implantation procedure were enrolled, and were divided into 4 groups, with 20 patients in each group. SIEMENS Definition AS40 CT was used for MSCT scanning with the low dose of 40 mA, 50 mA, 60 mA and the conventional dose of 90 mA in the 4 groups, respectively. Volume CT dose index (CTDIv) and dose length product (DLP) were calculated, and image quality was compared between the 4 groups. Results: Except that there was no significant difference in CTDIv, DLP between 60 mA and 90 mA groups, significant difference was found in CTDIv, DLP between any of the other 2 groups. Image quality between the 4 groups were similar. Conclusions: For MSCT, low dose of 40 mA not only can guarantee the image quality but also can meet the needs of preoperative evaluation of location for oral implantation procedure and may sharply decrease the radiation dose(35.0%).
[1] Brenner DJ, Hall EJ.Computed tomography--an increa-sing source of radiation exposure[J]. N Engl J Med,2007,357(22):2277-2284.
[2] Mathews JD, Forsythe AV, Brady Z, et al.Cancer risk in 680,000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians[J]. BMJ,2013,346:f2360.
[3] Sodickson A, Baeyens PF, Andriole KP, et al.Recurrent CT, cumulative radiation exposure, and associated radiation-induced cancer risks from CT of adults[J]. Radiology,2009,251(1):175-184.
[4] 董芬, 张彪, 单广良. 中国甲状腺癌的流行现状和影像因素[J]. 中国癌症杂志,2016,26(1):47-52.
[5] 韩晴, 黄汉林. 甲状腺疾病影响因素研究进展[J]. 中国职业医学,2015,42(3):345-347.
[6] 李永, 崔书君, 朱月香. 低剂量CT与常规剂量CT对早期肺癌的诊断价值对比[J]. 临床肺科杂志,2017,22(3):575-579.
[7] Haaga JR, Miraldi F, MacIntyre W, et al. The effect of mAs variation upon computed tomography image quality as evaluated by in vivo and in vitro studies[J]. Radiology,1981,138(2):449-454.
[8] 姜敏霞, 季中. 低剂量CT扫描在儿童口腔医学中的应用[J]. 中国辐射卫生,2010,19(2):190.
[9] 袁权, 陈方满, 郭平, 等. 低剂量MSCT在齿科扫描计划中的应用[J]. 皖南医学院学报,2015,34(3):286-288.
[10] 王远勤, 王臻, 吕杰, 等. 螺旋X-CT三维成像技术在口腔种植定位中的应用[J]. 广东牙病防治,2006,14(1):19-22.
[11] 李春元, 高振芹, 李雪松. 低剂量螺旋CT齿科成像技术在口腔种植定位术前评估中的价值[J]. 医学理论与实践,2014,27(5):574-575,592.
[12] 李春元. 低剂量螺旋CT齿科成像技术在口腔种植学中的应用进展[J]. 内蒙古中医药,2014,33(17):135-137.
[13] Lomasney LM, Steinberg MJ.Computerized imaging before patients undergo dental implantation[J]. Am J Roentgenol,1999,172(5):1439-1446.
[14] Naidich DP, Marshall CH, Gribbin C, et al.Low-dose CT of the lungs: preliminary observations[J]. Radiology,1990, 175(3):729-731.
[15] 邱晓晖, 章辉庆. 双源CT低辐射剂量冠状动脉CTA成像的应用现状及进展[J]. 安徽医学,2016,37(10):1309-1311.
[16] 吴梦雄, 曹琪琪, 杨文洁, 等. 正弦图确定迭代重建在低剂量胸部CT筛查中的应用[J]. 诊断学理论与实践,2017,16(1):104-108.
[17] 张京奕, 单丽华. 放射影像学检查在现代口腔种植学中的应用[J]. 河北医药,2008,30(5):693-695.
[18] 赵璟阳, 张善勇, 赵保东, 等. 影像学在口腔种植中的应用进展[J]. 中国口腔颌面外科杂志,2013,11(6):509-513.