探讨256iCT低剂量扫描在肺部小结节鉴别诊断中的应用  

Application of 256iCT low-dose scan in differential diagnosis of Small pulmonary nodules

作　　者：康书朝 崔凤[1] 来晓春[1] 叶斌[1] 瞿华[1] 邓国辉[1] 杨勇[1] 

机构地区：[1]浙江中医药大学附属广兴医院,杭州市中医院放射科,浙江杭州310007

出　　处：《中国现代医生》2016年第19期109-112,共4页China Modern Doctor

基　　金：浙江省科技厅项目(2013C03044-3)

摘　　要：目的 观察低剂量与常规剂量CT扫描对肺部小结节病灶显示的差异,探讨在肺部小结节鉴别诊断的早期肺癌筛查中低剂量CT应用的可能性。方法 选取应用常规剂量（120 k V/100 m As;滤波反投影法重建图像,FBP）检测出肺小结节患者46例,经患者知情同意3~24个月后隔期复查时采用低剂量参数（120 k V/50、30 m As;迭代算法重建图像,IR）扫描,分别对常规剂量组和低剂量组进行主观图像分析、评分,以及客观图像质量及辐射剂量比较。结果 两组图像均能清晰显示肺结节数目及形态特征,均能满足临床诊断要求,图像的CT值、SD值、SNR、CNR差异无统计学意义（P〉0.05）,两组图像质量没有区别;而两组在CTDIvol、DLP、ED方面比较,差异有统计学意义（P〈0.05）,低剂量组能明显降低患者所受辐射剂量。结论 低剂量扫描方案可以在肺部小结节鉴别诊断中大幅度降低患者所受辐射剂量,在早期肺癌筛查中值得临床推广。Objective To observe the displayed difference between low-dose and conventional-dose CT scan on small pulmonary nodules, and to discuss the possibility of low-dose CT in application of early screening of lung cancer with small pulmonary nodules. Methods 46 patients with small pulmonary nodules detected by conventional dose（120 kV/100 m As; filtered back projection reconstructed image, FBP） were selected and were given low-dose（120 kV/50, 30 m As;iterative algorithm reconstructed image, IR） CT scan on regular reexaminations from 3 to 24 months after the first scan.The subjective images were analyzed and scored in both conventional dose group and low dose group, and the objective quality of image and radiation dose were compared. Results Images of two groups can both clearly display the numbers and features of pulmonary nodules, meeting the need of clinical diagnosis. There were no significant differences in CT value, SD value, SNR, or CNR between two groups（P0.05）. There were significant differences in CTDIvol, DLP, and ED（P0.05）, and the radiation dose was significantly lower in the low dose group. Conclusion Low-dose CT scan can significantly reduce the radiation dose in the differential diagnosis of patients with small pulmonary nodules, thus is worthy to be promoted in early screening of lung cancer.

关 键 词：体层摄影术 X线计算机 辐射剂量 肺结节 

分 类 号：R816.41[医药卫生—放射医学]