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目的 探讨双上肢外展角度对车祸伤致双上肢不能上举患者肝脏CT平扫图像质量的影响及其临床应用价值.方法 纳入4组患者, 其中车祸伤致双上肢不能上举需行肝脏CT平扫的患者60例, 按患者双上肢外展成角区间分为3组 (A、B、C组), 每组20例;同时纳入标准体位对照组20例 (D组).测量4组患者肝脏兴趣区、竖脊肌、背景空气的CT值和标准偏差, 计算肝脏图像的对比噪声比、图像噪声值, 同时对图像整体质量进行评分并进行统计学分析.结果 80例患者均成功完成肝脏CT平扫.D组的图像整体质量明显优于A、B、C组 (Z=–10.753, P＜0.05;Z=–11.645, P＜0.05;Z=–12.281, P＜0.05);C组优于A、B两组 (Z=–8.502, P＜0.05;Z=–4.068, P＜0.05);B组优于A组 (Z=–5.885, P＜0.05).四组图像的CNR依次增大, 分别为A组 (0.09±0.77) 、B组 (1.56±0.83) 、C组 (2.51±0.87) 、D组 (2.59±0.97), 组间差异有统计学意义 (F=36.323, P＜0.05);图像噪声依次降低, 分别为A组 (14.84±2.94) 、B组 (13.04±1.59) 、C组 (11.60±1.72) 、D组 (10.44±1.13), 组间差异有统计学意义 (H=426.755, P＜0.05).结论 在安全受检的前提下, 车祸伤致双上肢不能上举的患者行肝脏CT平扫时, 随着双上肢外展成角区间的增大, 图像噪声降低, 信噪比增加, 得到的CT图像质量更高.“,”Objectives To investigate the influence of the abduction angle of the upper extremities on the image quality of non-enhanced CT scan and clinical value of the patients who cannot lift with double upper limbs by vehicle accident. Methods 60 patients with double upper limbs that could not lift by vehicle accidents were required to receive liver non-enhanced CT scan, the patients were divided into 3 groups according to the abduction angle (group A, B, C), 20 cases in each group, another 20 cases with standard pose as the control group (group D). The CT value and standard deviation of the liver region of interest, the erector and the background air were measured, and the contrast to noise ratio of liver images, image noise value were calculated, together with the assessment of image quality and statistic analysis. Results The liver non-enhanced CT scan were completed successfully. The image quality of group D was significantly better than A, B, C (Z=–10.753, P＜0.05; Z=–11.645, P＜0.05; Z=–12.281, P＜0.05), respectively. Group C was better than A and B (Z=–8.502, P＜0.05; Z=–4.068, P＜0.05), respectively. Group B was better than A (Z=–5.885, P＜0.05). The CNR of the four groups of images increased gradually, group A (0.09±0.77), group B (1.56±0.83), group C (2.51±0.87), group D (2.59±0.97), respectively. There were significant differences between four groups (F=36.323, P＜0.05). The image noise decreased systematically, group A (14.84±2.94), group B (13.04±1.59), group C (11.60±1.72), group D (10.44±1.13), respectively. There were significant differences between four groups (H=426.755, P＜0.05). Conclusion On the premise of safety inspection, with the enlargement of angle of the upper limbs of patients who cannot lift with double upper limbs by vehicle accidents, the image noise decreased and image quality is improved with the increase of signal noise ratio.