目的评估第3代双源CT自动管电压选择技术(CARE kV)行颞骨扫描在听力障碍儿童患者中的应用价值。方法将27例未满18岁患有听力障碍的儿童患者随机分为2组:A组(n=14):采用第2代双源CT和CARE kV及正弦图确定迭代重建技术;B组(n=13):采用第3代双源CT和CARE kV及高级模拟迭代重建技术。扫描范围为眉弓至乳突下缘。测量目标结构CT值及图像噪声,计算信噪比(SNR),对图像质量进行主观盲法评分。结果两组患者各解剖结构间的CT值、图像噪声和SNR差异均无统计学意义(P均>0.05)。两组患者10个解剖结构间的主观评分差异均无统计学意义(P均>0.05)。B组患者的CT容积剂量指数和剂量长度乘积分别为(11.62±1.92)m Gy和(106.92±37.48)m Gy·cm,较A组的(21.28±2.19)m Gy(t=12.15,P<0.001)和(229.65±56.26)m Gy·cm(t=6.62,P<0.001)分别降低了45%和53%。结论与第2代双源CT相比,第3代双源CT CARE kV技术颞骨扫描可在保证图像质量的前提下,明显降低辐射剂量。 Objective To assess the value of the third generation dual source CT automated tube voltage selection (CARE kV) technique in the diagnosis of pediatric hearing impaired children. Methods Twenty-seven children with hearing impairment under the age of 18 were randomly divided into two groups: group A (n = 14): the second generation dual-source CT and CARE kV and sinogram were used to determine the iterative reconstruction technique; group B ( n = 13): 3rd generation dual source CT and CARE kV and advanced analog iterative reconstruction techniques. Scanning range of brow to the lower edge of the mastoid. The target structure CT value and image noise are measured, the signal to noise ratio (SNR) is calculated, and the subjective blindness is graded on the image quality. Results There was no significant difference in CT value, image noise and SNR between the two groups (P> 0.05). There was no significant difference in the subjective scores of the 10 anatomical structures between the two groups (all P> 0.05). The CT volume dose index and dose length product of group B were (11.62 ± 1.92) m Gy and (106.92 ± 37.48) m Gy · cm, respectively, which was significantly higher than that of group A (21.28 ± 2.19) m Gy (t = 12.15, P < 0.001) and (229.65 ± 56.26) m Gy · cm (t = 6.62, P <0.001) decreased by 45% and 53%, respectively. Conclusion Compared with the second generation dual-source CT, the third-generation dual source CT CARE kV technique can reduce the radiation dose significantly under the premise of ensuring the image quality.