目的 探讨低辐射剂量、低对比剂用量和低注射流速在心血管CT造影(CTA)中的可行性,为临床诊疗提供影像学依据和参考.方法 选择2018年10月至2019年5月血管CTA检查患者80例作为对象,所有患者均行两次64排CT机动态容积CTA检查(初次检查、复查),患者初次检查时给予常规辐射剂量、对比剂用量及注射毒素方法检查,复查时采用低辐射剂量、低对比剂用量和低注射流速模式检查,将两次检查数据运用自适应统计迭代(ASIR)重建算法完成数据的处理,比较不同检查方法下图像的CT值、噪声、信噪比、有效辐射剂量(ED).结果 复查时给予低辐射剂量、低对比剂用量和低注射流速检查,患者图像质量5分、4分、3分、2分、1分病例数与初次检查患者比较,差异无统计学意义(P>0.05);复查患者主动脉根部、左侧冠状动脉主干及右侧冠状动脉近端图像的CT值、噪声、信噪比比较无统计学意义(P>0.05);复查时低辐射剂量、低对比剂用量和低注射流速下CTDlvol、DLP及ED辐射剂量,均低于初次检查时常规剂量(P<0.05).结论 将低辐射剂量、低对比剂用量和低注射流速用于心血管CTA检查中是可行的,能降低辐射剂量与对比剂用量,且不会影响图像质量,值得推广应用.

目的:分析X射线小肠钡剂造影与CT小肠造影在克罗恩病(CD)临床诊断中的应用及其对诊断肠壁增厚及肠外并发症的应用价值.方法:回顾性选取医院收治的79例CD患者资料,所有患者分别采用X射线小肠钡剂造影及腹部CT小肠造影两种不同检查方式,对比两种检查方式对患者裂隙状溃疡、卵石征、多节段性病变、肠壁增厚、强化增加、蜂窝织炎、炎性包块、腹腔囊肿等病变征象的差异.结果:X射线钡剂小肠造影的裂隙状溃疡和卵石征诊断检出率分别为51.90％和50.63％;CT小肠造影诊断检出率均为0.00％;其差异有统计学意义(x2=7.417,x2=7.295;P<0.05);两种检查方式对多节段性病变诊断的检出率比较,差异无统计学意义(x2=1.688,P>0.05);CT小肠造影检查对强化增加、蜂窝织炎、炎性包块和腹腔囊肿诊断的检出率高于X射线钡剂小肠造影;其差异均有统计学意义(x2=10.070,x2=7.173,x2=4.770,x2=6.161;P<0.05).结论:X射线钡剂造影能较好的检出裂隙状溃疡与卵石征,但对肠壁增厚及肠外并发症无诊断能力.X射线钡剂造影与CT造影在CD临床诊断中各具优势,需结合两种检查方式的优势综合判定,最大程度改善患者治疗与预后.

目的 探讨通过减少显影剂剂量来改善头颈CTA锁骨下静脉线束硬化伪影的成效.方法 本研究共招集58位病患进行头颈部CTA检查,依据所注射的显影剂差异将所有病例分为三组,A组:注射60 mL碘克沙醇、40 mL生理盐水;B组:注射50 mL碘克沙醇、50 mL生理盐水;C组:注射40 mL碘克沙醇、60 mL生理盐水.测量和比较感兴趣血管处CT值的差异;由两位高年资医师定性评估各组CTA图像质量的差异.结果 统计分析的结果发现,三组病患之升主动脉、降主动脉、左颈总动脉、右颈总动脉、左大脑中动脉、右大脑中动脉的CT值并无显著差异(P>0.05),但C组锁骨下静脉的CT值显著较A、B组的CT值低(P<0.05);比较图像质量的定性分析结果显示,C组右锁骨下静脉线束硬化伪影为三组中最低(P<0.05),而三之组最大密度投影重建后的图像质量并无统计学差异(P>0.05).结论 适度减少显影剂剂量可以改善头颈部CTA锁骨下静脉的线束硬化伪影.

Objective To evaluate the causes of DR waste film rates in different characteristic cases,and provide basis for quality control.Methods DR waste film rates of 98 503 cases from PACS were analyzed.All cases were grouped according to gender,age,X ray projection direction and projection position.The differences of DR waste film rates between the groups were compared.Results DR waste film rate in 98 503 cases was 4.89％ and factors that caused waste film were incorrect position,foreign materials,motion artifacts,machine problems and inappropriate X ray dosage.DR waste film rate was affected by gender,age,X ray projection direction,but not affected by projection position.Conclusion Analysis of DR waste film rate in different characteristic cases could provide basis for the quality control to reduce the DR waste film rate.

Objective:To reduce the re-radiation rate of X-ray in department of radiotherapy through applying quality management method of quality control circle (QCC).Methods: Through establishing QCC of department of radiotherapy, collecting all of advises, using various tools of quality management to analyze problem and propose improvement strategy for improving problem. The re-radiation rates of X-ray between pre-post improvement were compared to confirm the efficiency.Results: The re-radiation rate of X-ray reduced from 5.26％ to 3.89％ after the improvement strategy was implemented three months, and its magnitude of improvement was 26％.Conclusion:All of the improvement of QCC are divided into tangible result and intangible result. Through the implement of improving scheme, the shortened waiting time of imaging examination is tangible result, and the intangible result is that all of the members can more expertly use various analytical tools and methods and the cooperation is more closely among members during they take part in QCC.

Objective To study the DR (Digital Radiography) image re-photography factors resulting from bad image quality and related improvement measures. Methods Altogether 98503 cases in PACS (Picture Archiving and Communication System) were analyzed retrospectively to analyze the factors of the DR image re-photography and put forward related improvement measures. Pre- and post-improvement DR image re-photography ratios were compared. Results The DR image re-photography ratio was 4.89%and factors that caused re-photography included wrong position (2697 cases, 56.05%), foreign materials (990 cases, 20.57%), patients’ mobility (577 cases, 11.99%), machine fault (355 cases, 7.37%) and the inappropriate X-ray dosage (193 cases, 4.02%). Having taken improvement measures, the ratio of the DR image re-photography reduced from 4.38% to 3.81% in 6 months. Conclusion Regular analysis of the DR image re-photography factors and formulation of related improvement measures could improve the image quality, which were also effective measures for quality control and quality assurance.

乳腺癌是危害女性健康的常见恶性肿瘤，尤其是近些年来，乳腺癌的发病率有逐渐增加和年轻化的趋势。超声、钼靶、磁共振、断层扫描等影像检查方法已用于乳腺癌的筛查、诊断。通过系统分析诊断乳腺癌的常用影像学方法，为临床医生确诊乳腺癌提供参考。