低剂量CT扫描在诊断直径<2.0cm孤立性肺结节的临床价值  

Clinical Value of Low-dose CT Scan in Diagnosising Solitary Pulmonary Nodules with Diameter<2.0cm

作　　者：石锋[1] 舒松[1] 吴明[1] 杨维伟[1] 朱敏 SHI Feng;SHU Song;WU Ming;YANG Wei-wei;ZHU Min(Department of Radiology,the First People's Hospital of Tianmen City,Tianmen 431700,Hubei Province,China;Department of Radiology,Wuhan First Hospital,Wuhan 430022,Hubei Province,China)

机构地区：[1]湖北省天门市第一人民医院放射科,湖北天门431700 [2]湖北省武汉市第一医院放射科,湖北武汉430022

出　　处：《中国CT和MRI杂志》2021年第7期67-69,共3页Chinese Journal of CT and MRI

基　　金：湖北省自然科学基金(2016CFB752)。

摘　　要：目的探讨低剂量CT扫描在诊断直径<2.0cm孤立性肺结节(SPN)中的临床价值。方法回顾性分析2018年4月至2019年4月我院接诊的98例SPN患者的临床资料,均行常规剂量和低剂量CT扫描,比较低剂量组与常规组图像噪声、图像质量主观评分、辐射剂量,观察良恶性SPN低剂量CT的影像学特征,并评估不同剂量CT扫描对良恶性SPN的诊断效能。结果 98例患者中,共发现结节98个,其中良性结节34个,恶性结节64个;低剂量组剂量长度乘积(DLP)、容积CT剂量指数(CTDI)、有效管球剂量、总管球剂量均低于常规组(P<0.05);低剂量组与常规组图像噪声、图像质量主观评分比较,差异无统计学意义(P>0.05);与恶性SPN相比,良性SPN边缘清楚比例更高,毛刺、不规则或分叶比例更低,内部结构钙化、均匀比例更低,差异均有统计学意义(P<0.05);低剂量CT扫描与常规剂量CT扫描诊断良恶性SPN的灵敏度、特异度、准确率、阳性预测值及阴性预测值的差异均无统计学意义(P>0.05)。结论低剂量CT扫描对良恶性SPN的诊断效能与常规剂量相当,图像质量也能满足诊断需求,且辐射剂量更低,更适用于健康人群SPN筛查。Objective To investigate the clinical value of low-dose CT scan in diagnosising solitary pulmonary nodules(SPN)with diameter<2.0 cm.Methods The clinical data of 98 patients with SPN admitted to our hospital from April 2018 to April 2019 were retrospectively analyzed.Routine dose and low-dose CT scans were performed.The subjective score and radiation dose of image noise and image quality were compared between the low-dose group and the routine group,and the imaging features of lowdose CT of benign and malignant SPN were observed,and the diagnostic efficacy of different doses of CT scan on benign and malignant SPN were evaluated.Results Among 98 patients,98 nodules were found,including 34 benign nodules and 64 malignant nodules.The dose length product(DLP),volumetric CT dose index(CTDI),effective bulb dose and total bulb dose in the low-dose group were lower than those in the routine group(P<0.05).There were no significant differences in the subjective scores of image noise and image quality between the low-dose group and the routine group(P>0.05).Compared with malignant SPN,the clear margin ratio was higher,the ratios of burr,irregularity or lobulation were lower,and the ratios of internal structure calcification and homogeneity were lower in benign SPN(P<0.05).There were no significant differences in the sensitivity,specificity,accuracy rate,positive predictive value,and negative predictive value between low-dose CT scan and routine dose CT scan in the diagnosis of benign and malignant SPN(P>0.05).Conclusion The diagnostic efficacy of low-dose CT scan for benign and malignant SPN is comparable to that of routine dose,and the image quality can also meet the diagnostic needs,and the radiation dose is lower,thus low-dose CT scan is more suitable for SPN screening in healthy people.

关 键 词：低剂量 CT扫描 孤立性肺结节 辐射剂量 

分 类 号：R445.3[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]