甲状腺CT辐射剂量、图像质量与女性体成分的相关性研究

doi:10.19401/j.cnki.1007-3639.2025.04.010

摘要/Abstract

摘要：

背景与目的：计算机体层成像（computed tomography，CT）检查已成为有效剂量的主要来源之一。本研究通过分析甲状腺CT的辐射剂量、图像质量和女性体成分之间的相关性，为今后更好地控制辐射剂量和图像质量提供数据基础。方法：回顾性分析2015年1月—2019年12月在复旦大学附属肿瘤医院进行甲状腺CT检查的患者。收集甲状腺实质均匀区域的CT值和标准差值，相同感兴趣区（region of interest，ROI）大小测量邻近皮下脂肪组织的CT值和标准差值。所有数据需测3次取其均值，记录容积CT剂量指数（CT dose index of volume，CTDIvol）、剂量长度乘积（dose length product，DLP）并计算有效剂量值和各部位的信噪比（signal-to-noise ratio，SNR）、对比噪声比（contrast-to-noise ratio，CNR）。所有患者均接受骨密度检查，记录患者的身高、体重、体重指数（body mass index，BMI）、体表面积（body surface area，BSA）、脊柱与大腿肌肉百分比、脊柱与大腿脂肪百分比的数值。结果：104例患者纳入本研究。甲状腺CT图像的SNR和脊柱肌肉百分比（r=0.284，P=0.004）、CNR和脊柱脂肪百分比（r=0.197，P=0.045）、甲状腺CT图像的有效剂量和患者的年龄、体重、BMI、大腿脂肪百分比、BSA之间（r=0.221、0.247、0.260、0.262和0.222，P=0.024、0.011、0.008、0.007和0.024）均呈正相关。SNR和年龄、体重、BMI及脊柱脂肪百分比（r=-0.292、-0.198、-0.207、-0.284；P=0.003、0.044、0.035和0.004），CNR和脊柱肌肉百分比（r=-0.197，P=0.045），有效剂量和大腿肌肉百分比（r=-0.262，P=0.007）之间均呈负相关。结论：甲状腺CT的辐射剂量与女性体成分有相关性，图像质量与女性体成分的相关关系为今后更好地控制辐射剂量和提高图像质量提供了数据基础。

关键词: 辐射剂量, 体成分, 有效剂量, 信噪比, 对比噪声比

Abstract:

Background and purpose: With the increasing use of medical imaging examinations, Computed tomography (CT) scans have become one of the primary sources of effective dose. This study analyzed the correlation between radiation dose, image quality and body composition in thyroid CT to provide a data foundation for better control of radiation dose and image quality in the future. Methods: A retrospective analysis was conducted on patients who underwent thyroid CT scans at Fudan University Shanghai Cancer Center from January 2015 to December 2019. CT values and standard deviations (SD) of the homogeneous parenchyma of the thyroid were collected, and CT values and SD values of adjacent subcutaneous fat tissue were measured with the same region of interest (ROI) size. All data were measured three times to obtain the average value, and the volume CT dose index (CTDIvol) and dose-length product (DLP) were recorded. Effective dose values and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for various parts were calculated. All patients underwent bone density examinations, and patient height, weight, body mass index (BMI), body surface area (BSA), and the percentage of muscle and fat in the spine and thighs were recorded. Results: A total of 104 patients were enrolled in this study. The SNR of thyroid CT images and the percentage of spinal muscle (r=0.284, P=0.004), CNR of thyroid CT images and the percentage of spinal fat (r=0.197, P=0.045), and the effective dose of thyroid CT images and age, weight, BMI, thigh fat percentage, and body surface area (r=0.221, 0.247, 0.260, 0.262, and 0.222; P=0.024, 0.011, 0.008, 0.007 and 0.024) were positively correlated. While, SNR and age, weight, BMI, and the percentage of spinal fat (r=-0.292, -0.198, -0.207, and -0.284; P=0.003, 0.044, 0.035, 0.004), CNR and the percentage of spinal muscle (r=-0.197, P=0.045), and the effective dose and the percentage of thigh muscle (r=-0.262, P=0.007) were negatively correlated. Conclusion: The radiation dose in thyroid CT is correlated with female body composition. The image quality is related to female body composition, providing a data foundation for better control of radiation dose and image quality in the future.

Key words: Radiation dose, Body composition, Effective dose, Signal-to-noise ratio, Contrast-to-noise ratio

沈茜刚, 林呈祥, 彭卫军, 顾雅佳. 甲状腺CT辐射剂量、图像质量与女性体成分的相关性研究[J]. 中国癌症杂志, 2025, 35(4): 418-423.

SHEN Xigang, LIN Chengxiang, PENG Weijun, GU Yajia. A study on correlation between thyroid CT radiation dose, image quality and female body composition[J]. China Oncology, 2025, 35(4): 418-423.

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Index	TCTv1	TCTv2	TCTv3	MTCTv	TSDv1	TSDv2	TSDv3	MTSDv	SNR	MFCTv	MFSDv	CNR
Age	-0.234^*	-0.227^*	-0.250^*	-0.243^*	0.196^*	0.107	0.123	0.176	-0.292^**	-0.311^**	-0.03	0.004
Height	-0.138	-0.137	-0.164	-0.15	-0.026	-0.096	-0.035	-0.07	-0.004	-0.031	0.078	-0.143
Weight	-0.374^**	-0.379^**	-0.331^**	-0.371^**	0.13	0.04	-0.029	0.059	-0.198^*	-0.443^**	-0.065	-0.011
BMI	-0.342^**	-0.347^**	-0.287^**	-0.335^**	0.154	0.072	-0.016	0.089	-0.207^*	-0.444^**	-0.097	0.038
Thigh fat/%	-0.087	-0.08	-0.069	-0.081	-0.001	-0.006	0.068	0.023	-0.059	-0.363^**	-0.071	0.116
Thigh muscle/%	0.087	0.08	0.069	0.081	0.001	0.006	-0.068	-0.023	0.059	0.363^**	0.071	-0.116
Spine fat/%	-0.179	-0.221^*	-0.207^*	-0.208^*	0.154	0.152	0.108	0.176	-0.284^**	-0.637^**	-0.118	0.197^*
Spine muscle/%	0.179	0.221^*	0.207^*	0.208^*	-0.154	-0.152	-0.108	-0.176	0.284^**	0.637^**	0.118	-0.197^*
BSA	-0.371^**	-0.376^**	-0.338^**	-0.372^**	0.113	0.016	-0.034	0.039	-0.182	-0.412^**	-0.043	-0.04

Index	Sample size	Mean	SD	Measure of skewness	Kurtosis	The statistic D value	P value
MTCTv	104	159.506	19.236	0.318	1.362	0.073	0.186
MTSDv	104	9.561	2.755	0.762	1.090	0.075	0.149
SNR	104	18.013	5.468	0.881	0.934	0.098	0.015^*
MFCTv	104	-86.987	9.842	1.095	1.713	0.111	0.003^**
MFSDv	104	9.247	3.256	3.166	18.067	0.165	0.000^**
CNR	104	0.968	9.035	0.649	0.770	0.082	0.079
CTDI	104	13.089	3.735	1.023	1.572	0.120	0.001^**
DLP	104	309.049	70.142	0.490	-0.633	0.119	0.001^*
ED	104	1.669	0.379	0.489	-0.633	0.119	0.001^**
Age	104	52.486	11.596	-0.336	-0.559	0.109	0.004^*
Height	104	159.895	4.863	0.391	1.949	0.091	0.031^*
Weight	104	59.714	9.763	2.045	8.008	0.143	0.000^**
BMI	104	23.328	3.477	2.438	13.336	0.126	0.000^*
Thigh fat/%	104	26.952	4.202	0.321	1.784	0.053	0.662
Thigh muscle/%	104	73.048	4.202	-0.321	1.784	0.053	0.662
Spine fat/%	104	31.992	8.474	-0.318	-0.307	0.056	0.572
Spine muscle/%	104	68.008	8.474	0.318	-0.307	0.056	0.572
BSA	104	1.587	0.140	1.759	5.899	0.103	0.008^**

Index	CTDIvol	DLP	k value mSv/(mGy•cm)	ED
Age	0.084	0.222^*	0.0054	0.221^*
Height	-0.113	-0.022	0.0054	-0.022
Weight	0.264^**	0.248^*	0.0054	0.247^*
BMI	0.318^**	0.260^**	0.0054	0.260^**
Thigh fat/%	0.244^*	0.262^**	0.0054	0.262^**
Thigh muscle/%	-0.244^*	-0.262^**	0.0054	-0.262^**
Spine fat/%	0.233^*	0.179	0.0054	0.179
Spine muscle/%	-0.233^*	-0.179	0.0054	-0.179
BSA	0.218^*	0.222^*	0.0054	0.222^*