低剂量螺旋CT引导胸部穿刺活检的临床价值分析  

The clinical application study of low-dose CT-guided thoracic puncture biopsy

作　　者：霍祥辉 杨淑利 郭宗通 HUO Xianghui;YANG Shuli;GUO Zongtong(Imaging Department of Laiyang people's Hospital, Laiyang 265200, P.R.China;Department of Ultrasound, Maternal and Child Health Hospital, Puyang City, Puyang 457300, P.R.China;Imaging Department of Shandong Feicheng Mining Center Hospital, Feicheng 271608, P.R.China)

机构地区：[1]山东省莱阳市人民医院影像科,山东莱阳265200 [2]河南省濮阳市妇幼保健院超声科,河南濮阳457300 [3]山东省肥城矿业中心医院影像科,山东肥城271608

出　　处：《医学影像学杂志》2020年第12期2228-2231,共4页Journal of Medical Imaging

摘　　要：目的探讨低剂量螺旋CT引导胸部结节或肿块穿刺活检的应用价值。方法选取我院确诊的120例胸部结节或肿块患者,经CT引导下行胸部穿刺活检,对照组(60例)应用常规剂量参数:管电压120 kV、自动毫安秒,探测器宽度20 mm,螺距1.375,旋转时间0.8 s/转,重建层厚2.5 mm。观察组(60例)应用低剂量参数:管电流30 mA,其余参数与对照组相同。比较两组图像质量、穿刺成功率、诊断符合率、特异性、敏感性、并发症发生率、容积剂量指数(CTDIvol)和总剂量长度乘积(DLP),P<0.05说明差异具有统计学意义。结果对照组和观察组图像质量优良率、穿刺成功率均为100%,诊断符合率、敏感性、特异性、并发症发生率分别为98.3%、97.8%、100%、43.3%和96.7%、96.3%、100%、30%,差异均无统计学意义(P>0.05)。两组CTDIvol、DLP分别为(7.95±2.63)mGy、(294.43±80.22)mGy·cm和(1.42±0.26)mGy、(50.36±11.14)mGy·cm,差异具有统计学意义(P<0.05)。结论低剂量CT引导胸部穿刺活检的诊断符合率、特异性、敏感性与常规剂量CT比较无明显差异,不会降低穿刺成功率,图像质量无明显下降,患者在检查中所受辐射剂量显著降低。Objective To evaluate the application of low-dose helical CT-guided breast nodule or mass-penetrating biopsy.Methods A retrospective analysis of 120 cases of breast nodules or masses diagnosed in our hospital from June 2017 to April 2018 was reviewed.All the CT imagings were conducted at the conditions as below voltage 120 kV,automatic milliampere second,detector width 20 mm,the pitch 1.375,rotation time 0.8 s/r and reconstruction layer thickness 2.5 mm.For control group(60 cases),the tube current was applied atconventional dosemA,while it was low dose at 30 mA in the observation group(60 cases).The differences between two groups on image quality,rate of puncture,diagnostic coincidence rate,specificity,sensitivity,complication rate,volume dose index(CTDIvol)and total dose length product(DLP)were compared.Results There were excellent image quality in both groups with the diagnostic coincidence rate of 100%.the sensitivity,the specificity and the complication rate were 98.3%vs 97.8%,100%vs 43.3%,96.7%vs 96.3%,and 100%vs 30%,respectively(P>0.05).On the other hand,CTDIvol and DLP were(7.95±2.63)mGy and(294.43±80.22)mGy·cm for control group,while(1.42±0.26)mGy and(50.36±11.14)mGy·cm for observation group,with significant differences(P<0.05).Conclusion There are no significant differences between conventional dose group and low dose group in the diagnostic coincidence rate,specificity and sensitivity of CT guided chest biopsies.Low dose does not reduce the success rate of puncture,increase the incidence of complications,and significantly decrease the image quality,whiel on the ther hand,it significantly reduces the radiation dose of patients in the examination,which is worthy for clinical application.

关 键 词：胸部病变 体层摄影术 X线计算机 活检 辐射剂量 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]