自动管电流调制对髋关节机器人CT辐射剂量及图像质量的影响

doi:10.3969/j.issn.1674-8115.2025.11.009

上海交通大学学报（医学版） ›› 2025, Vol. 45 ›› Issue (11): 1502-1506.doi: 10.3969/j.issn.1674-8115.2025.11.009

• 论著 · 临床研究 • 上一篇

自动管电流调制对髋关节机器人CT辐射剂量及图像质量的影响

胡杰¹^,², 杨献峰¹^,²^,³()

^1.南京医科大学鼓楼临床医学院医学影像科，南京 210008
^2.南京大学医学院附属鼓楼医院医学影像科，南京 210008
^3.江苏省体育科学研究所，南京 210029

收稿日期:2025-04-16 接受日期:2025-06-06 出版日期:2025-11-28 发布日期:2025-12-03
通讯作者: 杨献峰，主任医师，博士；电子信箱：xianfeng9807@163.com。
基金资助:
江苏省体育局重大体育科研课题(STT221107);上海市人类运动能力开发与保障重点实验室开放课题(11DZ2261100);江苏省博士后科研资助计划(2021-188)

Effect of automatic tube current modulation on radiation dose and image quality of robotic-assisted hip CT

HU Jie¹^,², YANG Xianfeng¹^,²^,³()

^1.Department of Radiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing 210008, China
^2.Department of Radiology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
^3.Jiangsu Research Institute of Sports Science, Nanjing 210029, China

Received:2025-04-16 Accepted:2025-06-06 Online:2025-11-28 Published:2025-12-03
Contact: YANG Xianfeng, E-mail: xianfeng9807@163.com.
Supported by:
Jiangsu Province Sports Bureau Major Sports Research Project(STT221107);Shanghai Key Laboratory of Human Movement Ability Development and Support Open Project(11DZ2261100);Jiangsu Postdoctoral Research Funding Program(2021-188)

摘要/Abstract

摘要：

目的·探讨自动管电流调制（automatic tube current modulation，ATCM）降低髋关节机器人CT辐射剂量的可行性，并系统评估其对图像质量的影响。方法·纳入南京鼓楼医院2021年11月至2024年10月进行髋机器人CT检查的患者共106例。采用随机分组设计，将全部受检者随机分为2组，A组（56例）使用ACTM扫描，B组（50例）使用部分固定管电流扫描（髋关节）。以容积CT剂量指数（volume CT dose index，CTDIvol）和辐射长度乘积（dose-length product，DLP）作为辐射剂量评估指标，以图像信噪比（signal-to-noise ratio，SNR）、对比信噪比（contrast signal to ratio，CNR）和客观噪声作为图像质量评估指标。比较2组患者的年龄、性别、体质量指数（body mass index，BMI）、扫描长度、CTDIvol、DLP、SNR、CNR、客观噪声、建模图像合格率。结果·2组患者的性别、年龄、BMI、扫描长度、图像建模合格率、SNR、CNR、客观噪声比较，差异均无统计学意义（均P>0.05）。A组的髋关节CTDIvol和DLP低于B组，差异有统计学意义（均P<0.001）。结论·使用ACTM技术进行髋关节机器人术前CT扫描，可显著降低辐射剂量，同时保证CT图像质量满足髋关节机器人术前建模需要。

关键词: 髋关节, 机器人辅助技术, 自动管电流调制, 辐射剂量

Abstract:

Objective ·To evaluate the feasibility of automatic tube current modulation (ATCM) in reducing radiation dose during preoperative CT imaging for robotic-assisted hip arthroplasty and to assess its impact on image quality. Methods ·A total of 106 patients undergoing CT scans for robotic-assisted hip arthroplasty at Nanjing Drum Tower Hospital (from November 2021 to October 2024) were prospectively enrolled. Participants were randomly divided into Group A (n=56) and Group B (n=50).The patients in Group A underwent ATCM scanning, and the patients in Group B underwent partial fixed tube current scanning for hip imaging. Radiation dose parameters included volume CT dose index (CTDIvol) and dose-length product (DLP). Image quality was evaluated using signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and objective noise. Age, gender, body mass index (BMI), scan length, CTDIvol, DLP, SNR, CNR,noise,and image qualification rate were compared between the two groups. Results ·No statistically significant differences were observed between the two groups in baseline characteristics (gender, age, and BMI), scan length, image qualification rate, SNR, CNR, or objective noise (all P>0.05). However, Group A demonstrated significantly lower CTDIvol and DLP compared to Group B (both P<0.001). Conclusion ·The use of ATCM in preoperative CT imaging for robotic-assisted hip surgery significantly reduces radiation dose while maintaining image quality sufficient for 3D modeling requirements.

Key words: hip joint, robotic-assistive technology, automatic tube current modulation, radiation dose

中图分类号:

R445.3

胡杰, 杨献峰. 自动管电流调制对髋关节机器人CT辐射剂量及图像质量的影响[J]. 上海交通大学学报（医学版）, 2025, 45(11): 1502-1506.

HU Jie, YANG Xianfeng. Effect of automatic tube current modulation on radiation dose and image quality of robotic-assisted hip CT[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025, 45(11): 1502-1506.

图/表 4

参考文献 15

[1]	乔高山, 顾英骏, 朱乐银, 等. 前路辅助上方关节囊入路全髋关节置换对髋臼假体位置及术后早期髋关节功能的影响[J]. 骨科, 2023, 14(6): 517-522.
	QIAO G S, GU Y J, ZHU L Y, et al. Effect of total hip arthroplasty via anterior superpath approach on acetabular prosthesis position and early postoperative hip function[J]. Orthopaedics, 2023, 14(6):517-522.
[2]	LAWSON K A, AYALA A E, LARKIN K, et al. Anterior percutaneous-assisted total hip arthroplasty: surgical technique and early outcomes[J]. Arthroplast Today, 2020, 6(4): 716-720.
[3]	郭人文, 柴伟, 李想, 等. 机器人辅助在股骨头坏死全髋关节置换术中的应用[J]. 中华骨科杂志, 2020, 40(13): 819-827.
	GUO R W, CHAI W, LI X, et al. Short-term clinical outcomes of robotic-assisted total hip arthroplasty in osteonecrosis of the femoral head patients[J]. Chinese Journal of Orthopaedics, 2020, 40(13): 819-827.
[4]	许固军, 马明阳, 张帅, 等. Mako机器人辅助人工全髋关节置换术在发育性髋关节发育不良中的应用[J]. 中国修复重建外科杂志, 2021, 35(10): 1233-1239.
	XU G J, MA M Y, ZHANG S, et al. Application of Mako robot-assisted total hip arthroplasty in developmental dysplasia of the hip[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(10): 1233-1239.
[5]	蒋栋栋, 王亚囡, 周蕾, 等. 不同扫描体位和定位像方向对单髋关节CT图像及辐射剂量影响[J]. 影像科学与光化学, 2024, 42(1):23-28.
	JIANG D D, WANG Y N, ZHOU L, et al. Effects of different scanning position and scout orientation on CT images and radiation dose of unilateral Hip[J]. Imaging Science and Photochemistry, 2024,42(1): 23-28.
[6]	KIM H S, LEE Y K, HA J H, et al. Distribution and outliers of anteversion of short-length cementless stem[J]. Int Orthop, 2022, 46(4): 725-732.
[7]	BARRACK R L, KREMPEC J A, CLOHISY J C, et al. Accuracy of acetabular component position in hip arthroplasty[J]. J Bone Jt Surg, 2013, 95(19): 1760-1768.
[8]	王晓洋, 叶楠, 张志峰, 等. 机器人辅助技术在全髋关节置换术中的应用进展[J]. 实用骨科杂志, 2023, 29(9): 814-818.
	WANG X Y, YE N, ZHANG Z F, et al. Application progress of robot-assisted technology in total hip arthroplasty[J]. Journal of Practical Orthopaedics, 2023, 29(9): 814-818.
[9]	BENDICH I, VIGDORCHIK J M, SHARMA A K, et al. Robotic assistance for posterior approach total hip arthroplasty is associated with lower risk of revision for dislocation when compared to manual techniques[J]. J Arthroplasty, 2022, 37(6): 1124-1129.
[10]	涂源源, 万大地, 汪群力. 机器人辅助与传统人工全髋关节置换术后下肢长度差异的Meta分析[J]. 中国修复重建外科杂志, 2022, 36(5): 561-566.
	TU Y Y, WAN D D, WANG Q L. Meta-analysis of leg length discrepancy after robot-assisted and traditional total hip arthroplasty[J]. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(5): 561-566.
[11]	石泽锋, 孙可, 金先跃, 等. 国产机器人辅助全髋关节置换假体定位精准性的计算机体层成像评估[J]. 中国医疗器械信息, 2024, 30(15): 89-92.
	SHI Z F, SUN K, JIN X Y, et al. A CT study of accuracy and precision of prosthesis positioning in domestic robot-assisted total hip arthroplasty[J]. China Medical Device Information, 2024, 30(15): 89-92.
[12]	王静, 梁保辉, 王梦廷, 等. 定位像参数对智能管电压辅助技术联合自动管电流调制技术性能的影响[J]. 中国医疗设备, 2023, 38(3):21-25.
	WANG J, LIANG B H, WANG M T, et al. Influence of scanning parameters of the scout view on the performance of kV assist technology combined with automatic tube current modulation technology[J]. China Medical Equipment, 2023, 38(3): 21-25.
[13]	刘士远, 于红. CT低剂量扫描的研究和应用现状[J]. 中华放射学杂志, 2013, 47(4): 295-300.
	LIU S Y, YU H. Research and application status of low-dose CT scanning[J]. Chinese Journal of Radiology, 2013, 47(4): 295-300.
[14]	中华医学会放射学分会质量管理与安全管理学组. CT辐射剂量诊断参考水平专家共识[J]. 中华放射学杂志, 2017, 51(11): 817-822.
	Quality Management and Safety Management Section, Chinese Society of Radiology, Chinese Medical Association. Expert consensus on diagnostic reference levels for CT radiation dose[J]. Chinese Journal of Radiology, 2017, 51(11): 817-822.
[15]	王晨思, 洪瑶, 方慧敏, 等. 基于自动管电流调制技术下不同螺距对颈部CTA辐射剂量及图像质量影响的研究[J]. CT理论与应用研究, 2024, 33(3): 309-315.
	WANG C S, HONG Y, FANG H M, et al. Based on the effect of different pitches on neck CTA radiation dose and image quality under automatic tube current modulation technology[J]. CT Theory and Applications, 2024, 33(3): 309-315.

Index	Group A (n=56)	Group B (n=50)	Statistics	P value
Male/female/n	19/37	23/27	χ²=1.609	0.205
Age/year	51.71±15.33	52.02±14.25	z=0.180	0.857
BMI/kg·m^-2	25.76±4.30	26.01±3.74	t=-0.312	0.755
Scan length/mm	651.90±38.94	664.20±41.12	t=-1.580	0.117
Hip-DLP/(mGy·cm)	119.70±12.39	134.70±13.51	t=-5.971	<0.001
Hip-CTDIvol/mGy	3.04±0.22	3.21±0.25	z=-3.90	<0.001
Knee-DLP/mGy·cm	88.80±13.75	89.12±13.76	z=-1.73	0.084
Knee-CTDIvol/mGy	2.72±0.01	2.72±0.01	z=-0.91	0.361

Index	Group A (n=56)	Group B (n=50)	Statistics	P value
Male/female/n	19/37	23/27	χ²=1.609	0.205
Age/year	51.71±15.33	52.02±14.25	z=0.180	0.857
BMI/kg·m^-2	25.76±4.30	26.01±3.74	t=-0.312	0.755
Scan length/mm	651.90±38.94	664.20±41.12	t=-1.580	0.117
Hip-DLP/(mGy·cm)	119.70±12.39	134.70±13.51	t=-5.971	<0.001
Hip-CTDIvol/mGy	3.04±0.22	3.21±0.25	z=-3.90	<0.001
Knee-DLP/mGy·cm	88.80±13.75	89.12±13.76	z=-1.73	0.084
Knee-CTDIvol/mGy	2.72±0.01	2.72±0.01	z=-0.91	0.361

自动管电流调制对髋关节机器人CT辐射剂量及图像质量的影响

Effect of automatic tube current modulation on radiation dose and image quality of robotic-assisted hip CT

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 15

相关文章 12

编辑推荐

Metrics

[1]	王舒泽，王旭东 . 电子计算机断层扫描技术在手术中的应用进展[J]. 上海交通大学学报（医学版）, 2017, 37(6): 876-.
[2]	袁肖娜，高知玲，朱凯，等. 低剂量结合iDose迭代重建算法在上腹CT扫描中的应用[J]. 上海交通大学学报（医学版）, 2015, 35(9): 1325-.
[3]	贺慧慧，张敏，郭睿，等. 甲状腺乳头状癌术后¹³¹I治疗的住院时间探讨[J]. 上海交通大学学报（医学版）, 2015, 35(5): 724-.
[4]	杨斌，吴岩，李德艳，等. 智能最佳kV扫描技术在胸部CT扫描中的应用价值[J]. 上海交通大学学报（医学版）, 2013, 33(8): 1117-.
[5]	周晓凯, 易诚青, 马春辉, 等. 人工双极股骨头置换术治疗百岁老人股骨颈骨折2例报道[J]. , 2012, 32(12): 1564-.
[6]	马春辉, 易诚青, 李夏, 等. 全髋关节置换术治疗老年陈旧性股骨颈骨折的体会[J]. , 2012, 32(12): 1554-.
[7]	易诚青, 马春辉, 周晓凯, 等. 严重股骨近端畸形的全髋关节置换术中股骨侧重建策略[J]. , 2012, 32(12): 1549-.
[8]	易诚青, 马春辉, 李夏, 等. 髋臼内移技术在全髋关节置换术治疗髋关节发育不良中的应用[J]. , 2012, 32(12): 1544-.
[9]	朱金宏, 易诚青, 马春辉, 等. 骨小梁金属髋臼假体对人工全髋关节置换术后髋臼侧假体周围骨密度的影响[J]. , 2012, 32(12): 1540-.
[10]	曹云. 人工髋关节界面的研究现状与选择[J]. , 2012, 32(12): 1529-.
[11]	殷吉旻, 张长青, 李广翼, 等. 股骨颈骨折内固定术后股骨髋臼撞击综合征二例报道[J]. , 2010, 30(3): 363-.
[12]	金彪. 低剂量双源CT在儿童川崎病冠状动脉病变诊断中的应用[J]. , 2010, 30(12): 1540-.