摘要
目的比较微剂量与低剂量全肠道CT造影对儿童肠道疾病的诊断效能。方法选取因肠道疾病就诊患儿179例,均行全肠道CT造影。根据全肠道CT造影对比剂剂量不同分为微剂量全肠道CT造影组(微剂量组,n=90)和低剂量全肠道CT造影组(低剂量组,n=89),比较两组不同年龄段(3~6岁、7~10岁、11~14岁)患儿的CT图像质量、所受辐射有效剂量,并比较两组不良反应总发生率;以手术病理或内镜活检结果作为“金标准”,比较微剂量全肠道CT造影与低剂量全肠道CT造影诊断儿童肠道疾病的效能。结果两组不同年龄段患儿的CT图像质量优良率比较,差异无统计学意义(P>0.05);微剂量组3~6岁、7~10岁、11~14岁患儿所受辐射有效剂量低于低剂量组(P<0.05);微剂量组和低剂量组11~14岁患儿所受辐射有效剂量低于同组3~6岁、7~10岁患儿,7~10岁患儿所受辐射有效剂量低于3~6岁患儿(P<0.05);微剂量组不良反应总发生率低于低剂量组(P<0.05)。微剂量全肠道CT造影诊断儿童肠道疾病与手术病理或内镜活检结果的一致性较高(Kappa为0.897),准确度为93.33%(84/90);低剂量全肠道CT造影诊断儿童肠道疾病与手术病理或内镜活检结果的一致性较高(Kappa为0.933),准确度为95.51%(85/89),微剂量与低剂量全肠道CT造影诊断儿童肠道疾病的准确度比较差异无统计学意义(χ^(2)=0.358,P=0.572)。微剂量全肠道CT造影诊断儿童肠道疾病部位与手术病理或内镜活检结果的一致性较高(Kappa为0.922),准确度为93.33%(84/90);低剂量全肠道CT造影诊断儿童肠道疾病部位与手术病理或内镜活检结果的一致性较高(Kappa为0.947),准确度为95.51%(85/89),微剂量与低剂量全肠道CT造影诊断儿童肠道疾病部位的准确度比较差异无统计学意义(χ^(2)=0.462,P=0.513)。结论微剂量与低剂量全肠道CT造影对儿童肠道疾病的诊断效能均较高;与低剂量比较,微剂量全肠道CT造影可减少小儿所受辐射有效剂量且不影响图像质量。
Objective To compare the diagnostic efficacy of micro-dose and low-dose whole-intestinal CT imaging for intesti-nal diseases in children.Method A total of 179 children with intestinal diseases who were treated at the Tangshan Maternal and Child Health Hospital from January 2023 to March 2024 were collected,and all underwent whole-intestinal CT imaging.Ac-cording to the different doses of whole-bowel CT imaging,they were divided into a micro-dose group(n=90)and a low-dose group(n=89).The image quality and effective radiation dose received by the two groups of pediatric patients with intestinal dis-eases in different age groups were compared,and the total incidence of adverse reactions was compared between the two groups.Surgical pathology or endoscopic examination results were used as the"gold standard"to compare the diagnostic value of low-dose and low-dose whole-intestinal CT imaging for pediatric intestinal diseases.Results There was no significant difference in image quality between the micro-dose group and the low-dose group(P>0.05).The effective radiation dose of children with in-testinal diseases aged from 3 to 6 years old,7 to 10 years old and 11 to 14 years old in micro-dose group was lower than that in low-dose group(P<0.05).In microdose group and low dose group,the effective dose of intestinal diseases in 11-14 years old children was lower than that in 7-10 years old children and 3-6 years old children,and the effective dose of radiation in 7-10 years old children was lower than that in 3-6 years old children(P<0.05).The total incidence of adverse reactions in microdose group was lower than that in low-dose group(P<0.05).The consistency of micro-dose whole-intestinal CT imaging in diagnosing intestinal diseases in children with surgical pathology or endoscopic findings was 0.897,with an accuracy of 93.33%(84/90);The Kappa value of the consistency between the diagnosis of intestinal diseases in children by low-dose whole-body CT imaging and surgical pathology or endoscopic examination results was 0.933,with an accuracy of 95.51%(85/89).There was no signifi-cant difference in the accuracy of diagnosing intestinal diseases in children between the low-dose group and the micro-dose group(χ^(2)=0.358,P=0.572);The consistency of the diagnosis of intestinal diseases in children by micro-dose whole-intestinal CT imag-ing with surgical pathology or endoscopic findings was 0.922,with an accuracy of 93.33%(84/90).The Kappa value of the con-sistency between the diagnosis of intestinal disease location in children by low-dose whole-body CT imaging and surgical pathol-ogy or endoscopic examination results was 0.947,with an accuracy of 95.51%(85/89).There was no significant difference in the accuracy of diagnosing intestinal disease location in children between the low-dose whole-intestinal CT imaging and the micro-dose whole-intestinal CT imaging(χ^(2)=0.462,P=0.513).Conclusion Both micro-dose and low-dose whole-intestinal CT imag-ing have high diagnostic efficacy for intestinal diseases in children;Compared with low-dose CT,micro-dose whole-body CT im-aging can reduce the effective radiation dose for children without affecting image quality.
作者
黄子菡
刘振宇
张东香
张宁
HUANG Zihan;LIU Zhenyu;ZHANG Dongxiang;ZHANG Ning(Department of Radiology,Tangshan Meternal and Child Health Hospital,Tangshan 063000,China)
出处
《医学影像学杂志》
2025年第6期94-98,共5页
Journal of Medical Imaging
基金
2024年度河北省医学科学研究课题计划资助(编号:20241487)。
关键词
全肠道造影
体层摄影术
X线计算机
肠道疾病
疾病诊断
儿童
Whole-intestine imaging
Tomography,X-ray computed
Intestinal diseases
Disease diagnosis
Children
作者简介
黄子菡(1992-),女,大学本科,主治医师,主要从事儿科医学影像学诊断工作;通信作者:张宁,E-mail:gusi530356@163.com。
