小儿原发性纤毛运动障碍的超低剂量胸部计算机断层扫描与胸部x线摄影:一项前瞻性研究。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Michael G Waldron, Patrick W O'Regan, Michael Lane, Sahil S Shet, Eid Kakish, Fiachra Moloney, Niamh Moore, Mary Jane Murphy, Louise Beagan, Barry J Plant, David Mullane, Muireann Ni Chroinin, David J Ryan, Kevin O'Regan, Stephen P Power, Michael M Maher
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引用次数: 0

摘要

背景:原发性纤毛运动障碍(PCD)是一种罕见的疾病,其特征是纤毛运动障碍、不运动或缺失。由于呼吸粘膜纤毛清除功能受损,PCD患者通常会出现新生儿呼吸窘迫、鼻塞、中耳炎和反复呼吸道感染,导致支气管扩张和肺部结构性改变。胸部计算机断层扫描(CT)显示,这些变化发生在婴儿期和幼儿期。近年来降低辐射的CT技术的发展和改进使得辐射剂量显著降低,胸部CT剂量现在在胸部x线摄影(CR)的范围内。目的:评价超低剂量胸部CT (ULDCT)在诊断PCD患儿肺部病变中的作用。方法:在研究期间进行常规临床门诊随访的儿科PCD患者符合纳入研究的条件。对这些患者进行ULDCT和CR检查并比较结果。比较指标包括辐射剂量、主客观影像质量和疾病严重程度。结果:6例儿童患者(平均年龄9岁)接受了临床指示的ULDCT胸部检查和CR以监测其PCD。平均有效剂量为0.08±0.02毫西弗,与胸片正位和侧位的剂量相近。整个队列的平均Brody II得分为12.92,具有优秀的等级间信度和等级内相关系数(ICC)为0.98。CR的平均Chrispin-Norman评分为1分,评分间信度极佳,ICC为0.92。结论:与CR相比,ULDCT具有优越的诊断能力、最小的辐射剂量损失和较高的观察者间可靠性。因此,我们提倡将ULDCT作为儿科PCD监测成像的首选方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultra-low dose computed tomography chest vs chest radiography in paediatric primary ciliary dyskinesia: A prospective study.

Background: Primary ciliary dyskinesia (PCD) is a rare condition characterised by dysmotile, immotile, or absent cilia. As a result of the impairment in respiratory mucociliary clearance, patients with PCD typically develop neonatal respiratory distress, nasal congestion, otitis media and recurrent respiratory infections leading to bronchiectasis and structural lung changes. These changes have been shown by chest computed tomography (CT) to develop in infancy and early childhood. Recent development and refinement of radiation-reducing CT techniques have allowed significant radiation dose reductions, with chest CT doses now in the range of chest radiography (CR).

Aim: To evaluate the efficacy of ultra-low dose CT (ULDCT) chest in identifying pulmonary changes within a PCD paediatric patient cohort.

Methods: Paediatric patients with PCD who presented for routine clinical outpatient follow-up within the study period, were eligible for inclusion in the study. ULDCT and CR were performed on these patients and the results compared. Comparison metrics included radiation dose, subjective and objective image quality and disease severity.

Results: Six paediatric patients (mean age 9 years) underwent clinically indicated ULDCT chest examinations and CR for surveillance of their PCD. The mean effective dose was 0.08 ± 0.02 mSv, a dose that approximates that of a frontal and lateral chest radiograph. The average Brody II score across the entire cohort was 12.92, with excellent inter-rater reliability and intra-class correlation coefficient (ICC) of 0.98. The average Chrispin-Norman score on CR was 1 with excellent inter-rater reliability and ICC of 0.92.

Conclusion: ULDCT demonstrates superior diagnostic capabilities, minimal radiation dose penalty, and high interobserver reliability in comparison to CR. Thus, we advocate for ULDCT to be the preferred modality for surveillance imaging in paediatric PCD.

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来源期刊
World journal of radiology
World journal of radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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