多排螺旋CT低剂量扫描高分辨率重建在新型冠状病毒肺炎筛查中的应用  

Application of low-dose multidetector CT scan and high-resolution reconstruction in COVID-19 pneumonia screening

作　　者：王雁南 周俊林[2,3] 刘建莉 那飞扬[4] 周晟 WANG Yannan;ZHOU Junlin;LIU Jianli;NA Feiyang;ZHOU Sheng(First Clinical Medical School,Gansu University of Chinese Medicine,Lanzhou 730000,China;Department of Radiology,Lanzhou University Second Hospital,Lanzhou 730000,China;Key Laboratory of Medical Imaging in Gansu Province,Lanzhou 730000,China;Allergy Department,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730000,China;Department of Radiology,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]兰州大学第二医院放射科,甘肃兰州730000 [3]甘肃省医学影像重点实验室,甘肃兰州730000 [4]甘肃省妇幼保健院过敏反应科,甘肃兰州730000 [5]甘肃省中医院放射科,甘肃兰州730000

出　　处：《中国医学物理学杂志》2021年第4期456-460,共5页Chinese Journal of Medical Physics

基　　金：兰州市人才创新创业项目(2016-RC-58)。

摘　　要：目的:探讨多排螺旋CT(MDCT)低剂量扫描高分辨率重建在新型冠状病毒肺炎(COVID-19)筛查中的应用价值。方法:选取2020年2月1日~3月1日间就诊的66例疑似COVID-19肺炎患者作为研究对象,将66例患者随机平均分为2组,分别实施胸部常规剂量CT扫描(n=33, 120 kV, 300 mAs)和胸部低剂量CT扫描(n=33,100 kV,70 mAs),其中常规剂量组采用512×512矩阵,低剂量组采用1 024×1 024矩阵。同时对胸部低剂量组用4种不同权重的迭代算法进行处理(30%、50%、70%、90%),对比两种检查模式的辐射剂量和图像质量。结果:低剂量组的有效辐射剂量为(1.81±0.14)mSV,与常规剂量组(6.83±0.68)mSV相比降低73.5%(P<0.05);采用1 024大矩阵、90%权重迭代算法的低剂量组图像的CNR、SNR均略低于采用512常规矩阵、90%权重迭代算法的常规剂量组,但差异无统计学意义(SNR:5.11±0.75 vs 5.38±0.41,CNR:5.37±0.33 vs 5.44±0.51, P>0.05);低剂量组患者的肺窗、纵膈窗图像质量主观评分低于常规剂量组,但差异无统计学意义(肺窗:3.30±0.72 vs 3.39±0.78;纵膈窗:3.15±0.90 vs 3.36±0.82, P>0.05)。结论:使用MDCT进行胸部低剂量扫描,同时采用高分辨率重建技术及90%权重迭代算法可用于COVID-19肺炎筛查,可在保证图像质量的前提下显著降低患者所受辐射剂量。Objective To explore the application value of low-dose multidetector computed tomography(CT)scan combined with high-resolution reconstruction in the screening of COVID-19 pneumonia.Methods A total of 66 patients with suspected COVID-19 pneumonia who came to Lanzhou University Second Hospital from February 1,2020 to March 1,2020 were enrolled,and then randomly divided into 2 groups,namely conventional-dose CT scan group(n=33,120 kV,300 mAs)and low-dose CT scan group(n=33,100 kV,70 mAs).A 512×512 matrix was adopted in conventional-dose group,and a 1024×1024 matrix in lowdose group.Meanwhile,low-dose group was processed with 4 iterative algorithms with different weights(30%,50%,70%,90%).The radiation dose and image quality of two groups were compared.Results The effective radiation dose of low-dose group was(1.81±0.14)mSV,which was reduced by 73.5%(P<0.05)compared with(6.83±0.68)mSV in conventional-dose group.The contrast-to-noise ratio(CNR)and signal-to-noise ratio(SNR)of low-dose group with a 1024×1024 matrix and 90%weight iterative algorithm were slightly lower than those of conventional-dose group with a 512×512 matrix and 90%weight iterative algorithm,without statistical differences(SNR:5.11±0.75 vs 5.38±0.41,CNR:5.37±0.33 vs 5.44±0.51,P>0.05).The subjective image quality scores of pulmonary window and mediastinal window in low-dose group were lower than those in conventionaldose group,but the differences were not statistically significant(pulmonary window:3.30±0.72 vs 3.39±0.78;mediastinal window:3.15±0.90 vs 3.36±0.82,P>0.05).Conclusion Multidetector CT for low-dose scan combined with high-resolution reconstruction technique and 90%weight iterative algorithm can be applied for COVID-19 pneumonia screening,which can significantly reduce the radiation dose to patients while ensuring image quality.

关 键 词：多排螺旋CT 低剂量 高分辨率重建 新型冠状病毒肺炎 

分 类 号：R563.1[医药卫生—呼吸系统] R816.4[医药卫生—内科学]