不同剂量多层螺旋计算机断层扫描筛查尘肺病研究  

Different doses of multislice spiral CT in screening pneumoconiosis

作　　者：陈丽琨[1] 林锦明[1] 伍健芝[1] 曹子文[1] 刘贵喜[1] 

机构地区：[1]广东省职业病防治院,广东省职业病防治重点实验室,广东广州510300

出　　处：《中国职业医学》2016年第1期69-72,77,共5页China Occupational Medicine

基　　金：国家科技支撑计划项目(2014BAI12B01);国家临床重点专科建设项目(2011-09);广东省职业病防治重点实验室(2012A061400007);广东省医学科学技术研究基金(A2012075)

摘　　要：目的探讨不同剂量多层螺旋计算机断层扫描（MSCT）胸部扫描对尘肺病的筛查效果。方法采用随机抽样方法,抽取40名粉尘作业工人,分别采用常规剂量（管电压130 k V,管电流25.0~75.0 m As）与方案1（管电压110 k V,管电流50 m As）、方案2（管电压110 k V,管电流16.0 m As）、方案3（管电压80 k V,管电流16.0 m As）的低剂量扫描,分别对轴位1.5 mm薄层高分辨率重建、5.0 mm普通层厚高分辨率重建和5.0 mm厚层冠状位最大密度投影的重建图像进行对比分析。结果方案1和方案2的图像质量得分和低剂量MSCT图像评价得分均优于方案3（P〈0.01）。方案1和方案2的图像对40名研究对象的p、q、s和t小阴影均能显示;除方案2对t小阴影显示的得分外,方案1和方案2的图像对4种小阴影显示的得分分别与常规剂量组比较,差异均无统计学意义（P〉0.02）。方案3的图像对4种小阴影的显示明显减少,伪影较多;该方案的图像对p、q和t小阴影显示的得分均低于常规剂量组（P〈0.01）。评价MSCT辐射剂量的指标容积CT剂量指数、加权CT剂量指数、剂量长度乘积和平均有效剂量,在4种MSCT方案中从高到低均呈常规剂量组〉方案1组〉方案2组〉方案3组的趋势（P〈0.05）。结论低剂量MSCT方案可满足对尘肺病筛查的需要;采用管电压110 KV及管电流16 m As的方案在获得较好质量图像的同时,有利于降低筛查者接受的辐射量。Objective To explore the effects of different doses of chest multislice spiral computed tomography（ MSCT） in screening pneumoconiosis. Methods Forty workers exposed to coal dust and silica dust were selected by random sampling method,and scanned by conventional dose（ 130 k V,25. 0-75. 0 m As） and low-dose of MSCT which included program 1（ 110 k V,50. 0 m As）,program 2（ 110 k V,16. 0 m As） and program 3（ 80 k V,16. 0 m As） respectively. Comparative analysis was given to the reconstructions of high-resolution 1. 5 mm thin-section,5. 0 mm of ordinary-section and the maximum intensity projection of 5. 0 mm coronary position respectively. Results Program 1 and program 2 exceeded program 3 in both image quality scores and low-dose MSCT image evaluation score（ P〈0. 01）. Both program 1 and 2 were able to show the p,q,s and t small shadows of 40 cases,and had no statistical significant difference in small shadow scores compared with those of conventional dose group（ P〈0. 02）,except the t small shadow scores of program 2;program 3 distinctly showed fewer images of the 4 kinds of small shadow and more false images,its images of p,q and t small shadow scores were lower than those of conventional dose group（ P〈0. 01）. We evaluated the radiation dose indexes including the CT dose index volume,CT dose index weighted,dose length product and the average effective dose,and all the results showed the following trend sequence from high to low： the conventional dose group program 1 program 2 program 3 group（ P〈0. 05）. Conclusion All low doses of MSCT schemes can meet the demands of pneumoconiosis screening. Using the program of 110 k V,16. 0 m As can not only achieve better quality image,but also effectively reduce the radiation doses that patients receive in screening.

关 键 词：多层螺旋计算机断层扫描 低剂量 尘肺病 筛查 

分 类 号：R144[医药卫生—公共卫生与预防医学] X591[环境科学与工程—环境工程]