CT引导经皮穿刺活检中低剂量与超低剂量临床应用分析  

Analysis of the clinical application of CT-guided percutaneous biopsy with low and ultra low dose

作　　者：刘保东[1] 王博江[1] 孙新儒[1] 黄光明[1] 谭延禄 LIU Baodong;WANG Bojiang;SUN Xinru;HUANG Guangming;TAN Yanlu(Department of Interventional Oncology,Zibo Central Hospital,Zibo 255036,P.R.China)

机构地区：[1]山东省淄博市中心医院介入科,山东淄博255036

出　　处：《医学影像学杂志》2021年第7期1163-1167,共5页Journal of Medical Imaging

基　　金：山东省淄博市重点研发计划(政策引导类项目)(编号:2019ZC010065)。

摘　　要：目的探讨经皮肺穿刺活检术(percutaneous lung biopsy,PLB)中低剂量CT引导与超低剂量CT引导的临床效果及辐射剂量的差别。方法选取我院CT引导下PLB病例286例,其中低剂量组151例为对照组,超低剂量组135例为实验组。比较两组患者性别及年龄、病灶最大直径、皮肤到靶病灶的距离、手术操作时长、标本数量、病理诊断阳性率、辐射剂量、并发症发生率,同时比较两组图像质量对手术的影响。结果两组病例在患者性别、年龄、病灶最大直径、皮肤到靶病灶的距离等方面无显著差异(P>0.05)。标本数量、病理诊断阳性率及并发症发生率方面无统计学差异(P>0.05)。在手术操作时长方面,实验组用时更短(P<0.001)。在辐射剂量方面,实验组的剂量-长度乘积(dose-length product,DLP)为(47.5±11.6)mGy-cm,较对照组(216.7±93.5)mGy-cm下降了78.1%,差异有显著性(P<0.001)。两组图像质量的主观评价均满足穿刺需求。结论与低剂量CT相比,超低剂量CT引导的PLB,辐射剂量进一步减低的情况下,不增加手术时间,且可保证病理诊断阳性率和患者安全。Objective To retrospectively compare the clinical effect and radiation dose between low-dose and ultra-low-dose CT guided percutaneous lung biopsy(PLB).Methods A total of 286 cases of CT guided PLBs from 2016-8-1 to 2020-12-30 in our hospital were enrolled in this study,including low-dose CT group(n=151)as control group and ultra-low-dose CT group(n=135)as experimental group.The patients’gender and age,lesion size,skin to lesion depth,procedure time,number of specimens,pathological diagnostic accuracy rate,radiation dose and complication rate were compared between the two groups.At the same time,the effects of image quality on the operation were compared between the two groups.Results There was no significant difference in gender,age,lesion size,and skin to lesion depth between the two groups(P>0.05).No significant difference was found between the two groups concerning the number of specimens,pathological diagnostic accuracy rate and the complication rate(P>0.05).The procedure time of the experimental group was shorter than that of the control group(P<0.001).With regard to the radiation dose,the dose-length product(DLP)of the experimental group was(47.5±11.6)mGy-cm,which was 78.1%lower than that of the control group(216.7±93.5)mGy-cm,and the difference was significant(P<0.001).The subjective evaluation of the image quality of the two groups met the needs of biopsy.Conclusion Compared with Low-dose CT guided PLB,ultra-low-dose technique showed significant decrease of radiation dose,while maintaining high pathological diagnostic accuracy and safety without increasing of procedure time.

关 键 词：体层摄影术 X线计算机 辐射剂量 肺穿刺活检 

分 类 号：R814.42[医药卫生—影像医学与核医学] R734.2[医药卫生—放射医学]