基于BMI选择千伏降低CT引导下射频消融治疗肝脏肿瘤辐射剂量

doi:10.3969/j.issn.1006-6233.2023.02.031

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摘要 目的: 探讨基于体重指数(BMI)选择千伏对降低CT引导下射频消融治疗肝脏肿瘤辐射剂量的影响。方法: 回顾性分析2019年1月1日至2019年12月31日进行的CT引导下肝脏射频消融术(男55例、女45例;年龄29~90岁)。在以下每个步骤:术前计划CT扫描、术中监测电极针位置CT扫描和术后CT扫描,都记录了辐射剂量。随后,将基于BMI的方案修改的管电压改变应用于肝脏肿瘤消融术(男52例、女48例;年龄30~91岁)。记录每个病例的图像质量和总体操作者的满意度(评分1~5分)。然后计算修改后的剂量减少量。结果: 回顾性分析发现,CT引导下射频消融术的CT剂量指数(CTDIvol)为12.83±3.78mGy。方案修改后,平均CTDIvol下降至3.84±2.24mGy,总体降低70.07%。图像质量与修改前相比稍低,但两个阶段的图像质量均可满足CT引导下射频消融治疗肝脏肿瘤的需要。电极针显示和操作者的信心满意度差异没有统计学意义(P>0.05)。结论: 基于BMI的千伏修改可以显著降低CT引导下经皮肝脏肿瘤消融期间的辐射剂量,而不会显著降低图像质量。

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关键词 ：射频消融, 肝脏肿瘤, 辐射剂量, 低千伏, 体重指数

Abstract：Objective: To explore the effect of selecting kilovolts based on body mass index (BMI) on reducing the radiation dose of radiofrequency ablation in liver tumors under CT guidance. Methods: CT-guided RFA for hepatic ablations performed from January 1, 2019, through December 31, 2019, were retrospectively reviewed (55 men and 45 women; aged, 29~90 years). The radiation dose was recorded during each of the following steps: planning, performing, and postprocedure. BMI-based protocol modification changes in tube voltage and tube current were then applied to hepatic ablations performed subsequently (52 men and 48 women; aged 30~91 years). Image quality and overall operator satisfaction were noted for each case (score, 1~5). Dose reduction after modification was then calculated. Results: Retrospective analysis found a mean (± SD) overall CT dose index (CTDI) for CT-guided RFA to be 12.83±3.78mGy. After protocol modification, the mean CTDI decreased to 3.84 ±2.24 mGy, a 70.07% reduction overall. The image quality was slightly lower compared to before the modification, but the image quality in both stages met the needs of CT-guided radiofrequency ablation for liver tumors. The difference between electrode needle display and operator confidence satisfaction was not statistically significant (P> 0.05). Conclusion: BMI-based kilovolt modifications can significantly reduce the radiation dose during CT-guided percutaneous liver tumor ablation without significantly sacrificing image quality.

Key words： Radiofrequency ablation Liver tumor Radiation dose Low kilovolt Body mass index

基金资助:河北省医学科学研究课题,(编号:20201164)

通讯作者: 刘冲

引用本文:

赵君禄, 聂关伟, 赵炎, 刘冲, 郑立冬, 赵德园. 基于BMI选择千伏降低CT引导下射频消融治疗肝脏肿瘤辐射剂量[J]. 河北医学, 2023, 29(2): 336-339.
ZHAO Junlu, NIE Guanwei, LIU Chong, et al. Selecting Kilovolts to Reduce the Radiation Dose of CT-Guided Radiofrequency Ablation for Liver Tumors Based on BMI. HeBei Med, 2023, 29(2): 336-339.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.02.031 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I2/336