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肺部低劑量電腦斷層利用固定式管電流與自動管電流調控技術之比較

Low Dose Chest Computer Tomography Using between Fixed Tube Current and Automatic Tube Current Adjusting Technique

摘要


根據衛生福利部國民健康署2016年統計台灣十大死因第一位為癌症死亡,男性與女性肺癌的死亡率排名都在第三位,在癌症的死亡率而言卻是第一位,當今醫學對於肺癌早期發現是有較高的治癒率與存活率。現代醫學科技日新月異電腦斷層掃描儀對於肺部非鈣化微小結節的敏感度已大幅提升,目前已大規模應用於臨床檢查上,使用低劑量肺部電腦斷層掃描肺部做篩檢,能夠提早發現較微小的肺部病變,尤其適用於有肺部病史與高危險群民眾的定期篩檢。回溯本院病患收集從2014年3月到2018年7月之間進行肺部低劑量電腦斷層掃描並採用固定式管電流調控技術或自動管電流調控技術所接受的輻射劑量與相關的臨床數據進行分析;對於影像的清晰度方面也邀請兩位醫師及兩位從事電腦斷層檢查有10年以上工作經驗的資深放射師進行評分。此次的臨床數據採用t-test進行分析,最優先的探討在於使用固定式管電流調控技術與自動管電流調控技術上對於降低輻射劑量是否有顯著上的差異,其次是影像的清晰度採用五分法的方式來評比,最後還有病患BMI值與接受輻射劑量是否有相對應的關係,希望有效達到降低肺部電腦斷層掃描輻射劑量的最終目標同時也能維持著檢查的影像品質。

並列摘要


According to the 2016 statistics from National Health and Welfare Department, the first dying cause out of the top ten causes is cancer. In terms of the dying rate of lung cancer among males and females, it is on the third place. Yet, lung cancer is still the top one upon the cancer death rate. It is possibly curable if being found in the early stage of cancer. Due to the low dose computed tomography overcame the disadvantage of insensitivity of chest X-ray for non-calcified small nodules. Moreover, according to large scale clinical trials, applying low dose computer tomography on chest screening scan can discover more early stage removable lung cancer. Particularly suitable for the high risk group who have lung disorder history taking regular screening scan. This research looks into the different acceptable radiation dose of patient from fixed tube current regulation technology and automatic tube current regulation technology. It is able to provide moderate amount of dose precisely and effectively and further achieve the goal of low radiation dose scanning.

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