第三代双源CT低辐射剂量扫描对肺结节的诊断价值  

Diagnostic value of the third generation dual source CT in scanning pulmonary nodules by low radiation dose

作　　者：王辛华 周艳丽 刘晓林 周茂荣 孙凯 吕滨[3] Wang Xinhua;Zhou Yanli;Liu Xiaolin;Zhou Maorong;Sun Kai;Lyu Bin(Department of Radiology,Clinical Medicine of Baotou Medical College,Baotou Central Hospital,Baotou 014040,China;Department of Nuclear Medicine,Jinshan Hospital Affiliated to Tongji University,Shanghai 200135,China;Department of Radiology,Fuwai Hospital,Chinese Academy of Medical Sciences and National Cardiovascular Center,Beijing Union Medical College,Chinese Academy of Medical Sciences,Beijing 100037,China)

机构地区：[1]包头医学院中心临床医学院包头市中心医院影像科,014040 [2]同济大学附属金山医院核医学科,上海200135 [3]中国医学科学院北京协和医学院国家心血管病中心阜外医院放射影像科,100037

出　　处：《中华诊断学电子杂志》2018年第4期222-225,共4页Chinese Journal of Diagnostics(Electronic Edition)

基　　金：国家自然科学基金(81560286);国家十三五重大专项(2017YFC1307903);包头市科技计划项目(WSjj2015005)

摘　　要：目的探讨第三代双源CT筛查肺结节的临床诊断价值。方法选取2016年6月至2018年1月于包头市中心医院影像科行第三代双源CT和数字放射摄影(DR)肺部扫描的健康体检人群,共742例,收集其基本信息和影像资料。根据性别、年龄、有无吸烟史分组,采用卡方检验比较第三代双源CT非钙化肺结节检出率有无差异;采用卡方检验和两独立样本t检验比较CT和DR两种影像学方法的非钙化肺结节检出率和辐射剂量;以CT检出结果为结局指标,应用多因素Logistic回归分析影响肺结节发生的因素。结果男性组CT非钙化肺结节检出率(12.63%,37/293)与女性组(10.24%,46/449)比较,40岁≤年龄<50岁组(10. 14%,42/414)与年龄≥50岁组(12. 50%,41/328)比较,均差异无统计学意义(χ~2=1.01,1.02;均P>0. 05);吸烟组CT非钙化肺结节检出率为20. 00%(42/210),高于不吸烟组(7. 71%,41/532),差异具有统计学意义(χ~2=22. 90,P <0. 01)。DR肺结节检出率0. 94%(7/742)与CT肺结节检出率11.19%(83/742)比较,差异具有统计学意义(χ~2=76. 02,P <0. 05)。患者所受辐射剂量DR为(0.16±0.04) m Sv,与CT(0.28±0.06) m Sv比较,差异具有统计学意义(t=45.03,P <0.01)。多因素Logistic回归分析得出吸烟是肺结节的影响因素(OR=4.68,95%CI:2.15～10.18,P <0.01)。结论第三代双源CT大螺距扫描肺结节检出率明显高于DR,且辐射剂量比普通CT低,可在40岁以上人群肺部体检中推广。吸烟是发生肺结节的危险因素。Objective To explore the diagnostic value of the third generation dual source CT in screening pulmonary nodules. Methods From June 2016 to January 2018, the third generation dual source CT and DR aiming at healthy people were performed in the Department of Radiology of Baotou Central Hospital. A total of 742 cases′ basic information and image data were collected. Based on gender, age and smoking history, the detection rates of non-calcified lung nodules in the third generation dual source CT and DR were analyzed by chi-square test. The detection rates of non-calcified pulmonary nodules and radiation doses in two imaging methods were compared by chi-square test and t test of two independent samples. Multivariate Logistic regression analysis was used to analyze the influencing factors of pulmonary nodules based on the results of CT detection. Results The detection of non-calcified pulmonary nodules by CT in male group （12.63%, 37/293） compared with women group （10.24%, 46/449）, 40≤age 〈50 years old group （10.14%, 42/414） compared with aged 50 or more group （12.50%, 41/328）, there were no statistically significant differences in both （ χ 2 =1.01, 1.02, all P 〉0.05）. The non-calcified pulmonary nodule detection rate by CT in the smoking group was 20.00% （42/210）, which was significantly higher than that in the non-smoking group （7.71%, 41/532）, and the difference was statistically significant （ χ 2 =22.90, P 〈 0.01）. The detection rate of pulmonary nodules by DR was 0.94% （7/742）, and by CT was 11.19% （83/742）, the difference was statistically significant （ χ 2 =76.02, P〈0.05）.The average radiation dose of DR was （0.16±0.04） mSv and CT was （0.28±0.06） mSv, the difference was statistically significant （ t =45.03, P 〈0.01）. Multivariate Logistic regression analysis showed that smoking was the influencing factor of pulmonary nodules （ OR =4.68, 95% CI ：2.15-10.18, P 〈0.01）. Conclusions The third generation dual source CT has high detectio

关 键 词：肺结节 体层摄影术 X线计算机 诊断 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]