肺结核患者低剂量胸部螺旋CT扫描图像特点及临床诊断价值  

Image Characteristics and Clinical Diagnostic Value of Low-dose Chest Spiral CT in Patients with Pulmonary Tuberculosis

作　　者：沈明华[1] 庄雄杰[1] 王小平[1] 郭庆强[1] 郑宏伟 SHEN Minghua;ZHUANG Xiongjie;WANG Xiaoping;GUO Qingqiang;ZHENG Hongwei(The First Affiliated Hospital of Xiamen University,Xiamen 361003,China;不详)

机构地区：[1]厦门大学附属第一医院,福建厦门361003

出　　处：《中外医学研究》2021年第33期59-62,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：福建省卫生教育联合公关项目(WKJ2005-2-001)。

摘　　要：目的:分析肺结核患者低剂量胸部螺旋CT扫描图像特点及临床诊断价值。方法:回顾性选取2020年3月-2021年3月厦门大学附属第一医院放射科拟诊为肺结核患者128例为研究对象。依据诊断方式不同分为常规剂量组(64例,行常规剂量胸部CT扫描)及低剂量组(64例,行低剂量胸部螺旋CT扫描),观察两组病变扫描图像特点,对比其图像特征、影像学征象显示评分、剂量长度乘积(DLP)、CT剂量权重指数(CTDIW)、有效剂量,以病理结果为准,分析其临床诊断价值。结果:低剂量胸部螺旋CT扫描下,肺结核主要表现为小叶中心结节、多发干酪样坏死、肺实变、支气管扩张、淋巴结增大、磨玻璃影、毛刺征、条索状纤维性病变等典型影像学特征;低剂量组磨玻璃影、毛刺征显示评分均低于常规剂量组(P<0.05),两组其他典型影像学征象的显示评分比较差异均无统计学意义(P>0.05);低剂量组DLP、CTDIW、有效剂量均低于常规剂量组(P<0.05);以病理结果为准,低剂量胸部螺旋CT扫描诊断肺结核的敏感度、特异度、准确度与常规剂量CT扫描比较差异均无统计学意义(P>0.05)。结论:肺结核患者经低剂量胸部螺旋CT扫描诊断可在满足图像质量及诊断效能下,减少辐射剂量。Objective:To analyze the image characteristics and clinical diagnostic value of low-dose chest spiral CT in patients with pulmonary tuberculosis.Method:From March 2020 to March 2021,a total of 128 patients with pulmonary tuberculosis who were expected to be diagnosed in the radiology department of the First Affiliated Hospital of Xiamen University were selected as the study subjects.According to the different diagnostic methods,the patients were divided into conventional dose group (64 cases,routine dose of chest CT scan) and low-dose group (64 cases,low-dose chest spiral CT scan).The characteristics of pathological scan images of the two groups were observed,and the image characteristics,imaging sign display score,dose length product (DLP),CT dose weight index (CTDIW) and effective dose of the two groups were compared.The clinical diagnostic value of the two groups was analyzed based on pathological results.Result:Low-dose spiral chest CT showed typical image characteristics of pulmonary tuberculosis,such as centrilobular nodules,multiple caseous necrosis,lung consolidation,bronchiectasis,lymph node enlargement,ground glass shadow,burr sign,and cable fibrous lesions.The display scores of ground glass shadow and burr signs in the low-dose group were lower than those in the conventional dose group (P<0.05),and there were no significant differences in the scores of other typical image characteristics between the two groups (P>0.05).DLP,CTDIW and effective dose in low-dose group were lower than those in conventional dose group (P<0.05).Based on pathological results,there were no statistical significances in the sensitivity,specificity and accuracy of low-dose chest spiral CT scan in the diagnosis of pulmonary tuberculosis compared with conventional dose CT scan (P>0.05).Conclusion:The low-dose chest spiral CT scan can reduce the radiation dose while satisfying the image quality and diagnostic efficiency.

关 键 词：肺结核 低剂量胸部螺旋CT扫描 图像特点 诊断价值 

分 类 号：R816.41[医药卫生—放射医学] R521[医药卫生—临床医学]