低剂量螺旋CT扫描在支气管扩张症中的应用研究  

The application study of low-dose spiral CT scanning of bronchiectasis

作　　者：龙建新[1] 徐小平[1] 刘明炯[1] 刘永萍[1] 邱英良[1] 彭红星[2] 秦小玲[1] 宦丽群[1] 

机构地区：[1]南昌市第二医院CT室,南昌330003 [2]南昌市第二医院呼吸内科,南昌330003

出　　处：《江西医药》2010年第1期7-8,60,共3页Jiangxi Medical Journal

摘　　要：目的探讨低剂量螺旋CT扫描在检出肺段水平的支气管扩张(支扩)中的价值,评估其影像效果。方法(1)对40例临床诊断为支扩者进行检查。每位受检者均先行胸部常规剂量CT扫描,并对部分肺段进行低剂量CT扫描和HRCT扫描;(2)根据诊断的把握度将各肺段有否支扩用肯定是支扩、不能确定和肯定不是支扩进行评判。(3)图像质量评价:由2名CT医生按正常图像、图像有少许伪影、图像有严重伪影的等级对低剂量CT图像进行评判。结果(1)40例患者共430个肺段进行了低剂量CT和HRCT扫描。(2)经Kappa法检验,低剂量CT和HRCT两种方法在发现和诊断支扩中具有良好的一致性(Kappa值0.77)。以HRCT发现和诊断的支扩为标准,低剂量CT对支扩的敏感度91%、阳性预测值94%、准确度96%。(3)低剂量CT图像噪声水平增加,但98%以上图像可满足诊断需要。结论低剂量螺旋CT扫描在检出肺段水平的支扩中具有很高的价值,有望提高支扩的早期发现。它的正确应用可以有效地保护病人和保证图像质量。有条件者可开展低剂量CT筛查支扩。Objective To explore the detection value of bronchiectasis at segmental level and evaluate the imaging quality of low-dose spiral CT scanning. Methods （1） 40 cases with doubted by clinical evaluation were selected, and performed low-dose CT and HRCT scanning after having perform standard-dose CT scanning examinatlon.（2）Bronchiectasis were explored by diagnostic confi- dence （＂definite bronchiectasis＂, ＂questionable bronchiectasis＂, and ＂definite not bronehiectasis＂）. （3）CT images were evaluated by two doctors using blind method, and analyzed 3 degrees including normal image, image with few artifact,and image with excessive artifact. Results （1）40 cases （430 segments） were examined by using with low-dose CT and HRCT scanning. （2）The group of low-dose CT had a good coincidence with HRCT group by Kappa test （the Kappa values was 0.77）. The sensitivity of low-dose CT group was 91%, the positive predictive value was 94%, the correction rate was 96%.（3）Low-dose CT scanning of the noise level were more high- er,but 98% low-dose CT image was full readable.Conclusion Low-dose CT scanning have very high diagnostic values of bronchiec- tasis at segmental level and is expected to improve early deteetion of bronchiectasis.It may proteet the patients and guarantee the imaging quality with proper employment. Low-dose CT scanning for bronchiectasis may be applied if situation permits.

关 键 词：支气管扩张 体层摄影术 X线计算机 低剂量 

分 类 号：R816.41[医药卫生—放射医学]