Pilot Study of Radiation Dose Reduction for Pediatric Head CT in Evaluation of Ventricular Size
Pilot Study of Radiation Dose Reduction for Pediatric Head CT in Evaluation of Ventricular Size
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DOI：
10.3174/ajnr.a4056
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发表时间：
2014-12-01
影响因子：
3.5
通讯作者：
Yu, L.
中科院分区：
文献类型：
--
作者：
Gabriel, S.;Eckel, L. J.;Yu, L.
背景和目的：CT是评估儿童脑室大小的一种普遍、有效和经济的方法，特别是对于经常需要紧急成像的脑脊液分流患者。因此，我们试图确定产生临床可接受检查所需的最小剂量输出或CT剂量指数。材料和方法：使用经过验证的噪声插入法和来自22名患者的CT投影数据，对标准的儿科头部CT图像进行加权滤波反投影和正弦图确认迭代重建，分别对应于常规、25%和10%剂量。然后由3位神经放射科医生(对剂量和重建方法盲法)对重建图像的脑室大小、诊断可信度、图像质量、出血证据和分流尖端位置进行评估，并与参考标准进行比较。结果：脑室大小分级无明显差异，对中、重度脑积水的敏感度为100%。对于任何重建核，在25%或10%剂量水平下，全剂量水平和脑室大小排名之间没有显著差异(P>；.979)。诊断的可信度在不同剂量和不同内核之间保持不变。出血更难识别，因为图像质量随着剂量的减少而下降，但在大多数病例中仍可见。所有读者在所有剂量和重建方法中都能识别分流。结论：与常规头部CT检查相比，剂量减少90%的CT图像提供了可接受的图像质量，以满足评估脑室大小的特定临床任务。
BACKGROUND AND PURPOSE: CT is a ubiquitous, efficient, and cost-effective method to evaluate pediatric ventricular size, particularly in patients with CSF shunt diversion who often need emergent imaging. We therefore sought to determine the minimum dose output or CT dose index required to produce clinically acceptable examinations.MATERIALS AND METHODS: Using a validated noise insertion method and CT projection data from 22 patients, standard pediatric head CT images were reconstructed with weighted filtered back-projection and sinogram-affirmed iterative reconstruction corresponding to routine, 25%, and 10% dose. Reconstructed images were then evaluated by 3 neuroradiologists (blinded to dose and reconstruction method) for ventricular size, diagnostic confidence, image quality, evidence of hemorrhage, and shunt tip location, and compared with the reference standard.RESULTS: There was no significant difference in the ventricular size ranking, and the sensitivity for moderate to severe hydrocephalus was 100%. There was no significant difference between the full-dose level and the ventricular size rankings at the 25% or the 10% dose level for either reconstruction kernel (P > .979). Diagnostic confidence was maintained across doses and kernel. Hemorrhage was more difficult to identify as image quality degraded as dose decreased but was still seen in a majority of cases. Shunts were identified by all readers across all doses and reconstruction methods.CONCLUSIONS: CT images having dose reductions of 90% relative to routine head CT examinations provide acceptable image quality to address the specific clinical task of evaluating ventricular size.