Influence of the abduction angle of the double upper limbs on liver non-enhanced CT image quality in patients with vehicle accident_Chinese Journal of Evidence-Based Medicine

Authors：

PU Jin , WANG qiang , XIA Chunchao ,  LI Zhenlin

Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding?author：

LI Zhenlin, Email: zlcd01@126.com

Keywords：

Upper limb; Liver; Abduction angle; CT

DOI：

10.7507/1672-2531.201711059

Video：

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ObjectivesTo investigate the influence of the abduction angle of the upper extremities on the image quality of non-enhanced CT scan and clinical value of the patients who cannot lift with double upper limbs by vehicle accident.Methods60 patients with double upper limbs that could not lift by vehicle accidents were required to receive liver non-enhanced CT scan, the patients were divided into 3 groups according to the abduction angle (group A, B, C), 20 cases in each group, another 20 cases with standard pose as the control group (group D). The CT value and standard deviation of the liver region of interest, the erector and the background air were measured, and the contrast to noise ratio of liver images, image noise value were calculated, together with the assessment of image quality and statistic analysis.ResultsThe liver non-enhanced CT scan were completed successfully. The image quality of group D was significantly better than A, B, C (Z=–10.753, P<0.05;Z=–11.645, P<0.05;Z=–12.281, P<0.05), respectively. Group C was better than A and B (Z=–8.502, P<0.05;Z=–4.068, P<0.05), respectively. Group B was better than A (Z=–5.885, P<0.05). The CNR of the four groups of images increased gradually, group A (0.09±0.77), group B (1.56±0.83), group C (2.51±0.87), group D (2.59±0.97), respectively. There were significant differences between four groups (F=36.323, P<0.05). The image noise decreased systematically, group A (14.84±2.94), group B (13.04±1.59), group C (11.60±1.72), group D (10.44±1.13), respectively. There were significant differences between four groups (H=426.755, P<0.05).ConclusionOn the premise of safety inspection, with the enlargement of angle of the upper limbs of patients who cannot lift with double upper limbs by vehicle accidents, the image noise decreased and image quality is improved with the increase of signal noise ratio.

Citation： PU Jin, WANG qiang, XIA Chunchao, LI Zhenlin. Influence of the abduction angle of the double upper limbs on liver non-enhanced CT image quality in patients with vehicle accident. Chinese Journal of Evidence-Based Medicine, 2018, 18(5): 454-458. doi: 10.7507/1672-2531.201711059 Copy

1.	宋彬, 黃子星. CT 檢查在腹部創傷診療中的應用價值. 中國普外基礎與臨床雜志, 2015, 22(3): 263-268.
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5.	袁知東, 劉遠健, 江國銀, 等. 雙上肢均不能上舉患者胸腹部 CT 掃描技術改進. 中華放射學雜志, 2010, 44(2): 198-201.
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11.	武永杰, 趙宏亮, 魏夢綺, 等. 低濃度對比劑大螺距前門控雙源 CT 冠狀動脈成像初步研究. 放射學實踐, 2015, 30(5): 554-559.
12.	姜健, 王可, 許玉峰, 等. 低輻射劑量肝臟 CT 增強掃描: 80 kVp 結合迭代重建技術的初步研究. 放射學實踐, 2016, 31(4): 316-320.
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14.	曹國全, 蔡志敏, 陳勇春, 等. 低管電壓聯合迭代重建算法對胸部 CT 血管造影圖像質量及輻射劑量的影響. 中華放射醫學與防護雜志, 2015, 35(5): 393-396.
15.	雍敏, 畢純龍, 萬霞, 等. 雙源 CT 低管電壓大螺距(Flash)模式聯合迭代重組在主動脈 CTA 中的應用研究. 臨床放射學雜志, 2015, 34(9): 1505-1509.
16.	Pontana F, Pagniez J, Duhamel A, et al. Reduced-dose low-voltage chest CT angiography with Sinogram-affirmed iterative reconstruction versus standard-dose filtered back projection. Radiology, 2013, 267(2): 609-618.
17.	武永杰, 鄭敏文, 趙宏亮, 等. 低濃度對比劑聯合應用低 kV 和迭代重建技術的冠狀動脈雙源 CT 成像可行性. 中華醫學雜志, 2014, 94(29): 2260-2263.
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19.	王倩, 趙心明, 宋俊峰, 等. 自動管電流調制技術對腹部 CT 圖像質量及輻射劑量影響的體模研究. 中華放射學雜志, 2013, 47(7): 648-653.
20.	Irie T, Inoue H. Individual modulation of the tube current-seconds to achieve similar levels of image noise in contrast-enhanced abdominal CT. AJR Am J Roentgenol, 2005, 184(5): 1514-1518.

1. 宋彬, 黃子星. CT 檢查在腹部創傷診療中的應用價值. 中國普外基礎與臨床雜志, 2015, 22(3): 263-268.
2. Abujudeh HH, Kaewlai R, McMahon PM, et al. Abdomino-pelvic CT increases diagnostic certainty and guides management decisions: a prospective investigation of 584 patients in a large academic medical center. AJR Am J Roentgenol, 2011, 196(2): 238-243.
3. Barajas RF Jr, Yeh BM, Webb EM, et al. Spectrum of CT findings in patients with atrial fibrillation and nontraumatic acute abdomen. AJR Am J Roentgenol, 2009, 193(2): 485-492.
4. Salem TA, Molloy RG, O'Dwyer PJ. Prospective study on the role of the CT scan in patients with an acute abdomen. Colorectal Dis, 2005, 7(5): 460-466.
5. 袁知東, 劉遠健, 江國銀, 等. 雙上肢均不能上舉患者胸腹部 CT 掃描技術改進. 中華放射學雜志, 2010, 44(2): 198-201.
6. 朱衛平, 王振, 鐘建國, 等. 手臂上舉姿勢對胸部多層 CT 掃描自動管電流曝光技術的影響. 中華放射學雜志, 2012, 46(10): 948-949.
7. Brink M, de Lange F, Oostveen LJ, et al. Arm raising at exposure-controlled multidetector trauma CT of thoracoabdominal region: higher image quality, lower radiation dose. Radiology, 2008, 249(2): 661-670.
8. 張偉, 龐小嬌, 龔建平, 等. 足頭側掃描方向對提高胸部血管成像圖像質量的價值. 臨床放射學雜志, 2014, 33(4): 609-611.
9. 陸東旭, 王瑞, 范占明, 等. 雙低劑量全主動脈 CT 血管成像臨床應用研究. 中國 CT 和 MRI 雜志, 2015, 13(4): 117-120.
10. Nakayama Y, Awai K, Funama Y, et al. Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise. Radiology, 2005, 237(3): 945-951.
11. 武永杰, 趙宏亮, 魏夢綺, 等. 低濃度對比劑大螺距前門控雙源 CT 冠狀動脈成像初步研究. 放射學實踐, 2015, 30(5): 554-559.
12. 姜健, 王可, 許玉峰, 等. 低輻射劑量肝臟 CT 增強掃描: 80 kVp 結合迭代重建技術的初步研究. 放射學實踐, 2016, 31(4): 316-320.
13. 張麗, 于紅, 劉士遠, 等. 迭代重建技術對肺部平掃 CT 圖像質量的影響. 中華放射學雜志, 2013, 47(4): 316-320.
14. 曹國全, 蔡志敏, 陳勇春, 等. 低管電壓聯合迭代重建算法對胸部 CT 血管造影圖像質量及輻射劑量的影響. 中華放射醫學與防護雜志, 2015, 35(5): 393-396.
15. 雍敏, 畢純龍, 萬霞, 等. 雙源 CT 低管電壓大螺距(Flash)模式聯合迭代重組在主動脈 CTA 中的應用研究. 臨床放射學雜志, 2015, 34(9): 1505-1509.
16. Pontana F, Pagniez J, Duhamel A, et al. Reduced-dose low-voltage chest CT angiography with Sinogram-affirmed iterative reconstruction versus standard-dose filtered back projection. Radiology, 2013, 267(2): 609-618.
17. 武永杰, 鄭敏文, 趙宏亮, 等. 低濃度對比劑聯合應用低 kV 和迭代重建技術的冠狀動脈雙源 CT 成像可行性. 中華醫學雜志, 2014, 94(29): 2260-2263.
18. 胡敏霞, 趙心明, 宋俊峰, 等. 64 層螺旋 CT 腹部掃描參數優化的初步研究. 中華放射學雜志, 2011, 45(3): 264-269.
19. 王倩, 趙心明, 宋俊峰, 等. 自動管電流調制技術對腹部 CT 圖像質量及輻射劑量影響的體模研究. 中華放射學雜志, 2013, 47(7): 648-653.
20. Irie T, Inoue H. Individual modulation of the tube current-seconds to achieve similar levels of image noise in contrast-enhanced abdominal CT. AJR Am J Roentgenol, 2005, 184(5): 1514-1518.

Chinese Journal of Evidence-Based Medicine

Influence of the abduction angle of the double upper limbs on liver non-enhanced CT image quality in patients with vehicle accident

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