不同剂量CT扫描对肺结节的检出率及人工智能辅助的应用价值  

Detection rate of pulmonary nodules by CT scan at different doses and application value of artificial intelligence assistance

作　　者：贡鸣[1] 张斌斌[1] 董志明 常泰[1] Gong Ming;Zhang Binbin;Dong Zhiming;Chang Tai(Department of Radiology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院放射科,北京100010

出　　处：《中国医师进修杂志》2023年第6期529-533,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨不同剂量CT扫描对肺结节(PN)的检出率及人工智能(AI)系统辅助的应用价值。方法回顾性选取2019年10月至2021年10月在首都医科大学附属北京中医医院诊治的210例PN患者,按CT扫描剂量的不同分为研究组(106例)和对照组(104例),对照组采用胸部常规平均剂量(169 mAs)CT扫描,研究组采用胸部低平均剂量(54 mAs)CT扫描。比较两组不同性别、年龄、体质量指数(BMI)的PN检出率,并比较两组PN的形态学特征、辐射剂量、CT图像质量,比较放射科医师与AI系统低剂量CT扫描的PN检出率。结果研究组PN检出率为73.58%(78/106),对照组PN检出率为80.77%(84/104),两组PN检出率比较差异无统计学意义(χ^(2)=1.54,P>0.05);两组不同性别、年龄段、BMI的患者PN检出率比较差异均无统计学意义(P>0.05)。两组PN直径及钙化、空洞、支气管征、分叶征、毛刺征、胸膜粘连征检出率比较差异无统计学意义(P>0.05)。研究组有效管球剂量、辐射剂量的长度乘积、总管球剂量、放射容积剂量指数均低于对照组[(46.15±7.38)mAs比(104.39±10.53)mAs、(169.24±19.77)mGy·cm比(427.17±43.58)mGy·cm、(972.65±58.34)mAs比(2861.26±181.37)mAs、(3.55±1.16)mGy比(8.95±2.07)mGy],差异有统计学意义(P<0.05)。研究组1.0 mm图像质量优、良、可、差分别为26、60、18、2例,对照组分别为32、64、8、0例,两组1.0 mm图像质量比较差异无统计学意义(u=1.71,P=0.087)。研究组最大密度投影(MIP)图像质量优、良、可、差分别为58、42、6、0例,对照组分别为70、34、0、0例,两组MIP图像质量比较差异无统计学意义(u=1.81,P=0.070)。放射科医师对低剂量CT胸部扫描的PN检出率为73.58%(78/106),而采用AI系统低剂量CT扫描PN检出率为88.68%(94/106),两者比较差异有统计学意义(χ^(2)=7.89,P=0.005)。结论低剂量CT扫描对PN的检出率、形态学特征结果、CT图像质量与常规剂量CT扫描基本一致,且能大幅降低辐Objective To investigate the detection rate of pulmonary nodules(PN)by CT scan at different doses and the application value of artificial intelligence(AI)system assistance.Methods From October 2019 to October 2021,210 patients with PN in Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,were retrospectively selected,and they were divided into the study group(106 cases)and the control group(104 cases)by CT scan at different doses.The control group used the conventional average dose(169 mAs)CT scan,the study group used an average low-dose(54 mAs)CT scan.The PN detection rate of different gender,age,body mass index(BMI)between the two groups were compared.The morphological characteristics,radiation dose,CT image quality between the two groups were compared.The diagnostic efficiency of radiologists and AI system was compared.Results The detection rate of PN in the study group and the control group had no significant difference:73.58%(78/106)vs.80.77%(84/104),χ^(2)=1.54,P>0.05.The detection rate of PN with different gender,age group and BMI in the two groups had no significant differences(P>0.05).The diameter of nodules and the rates of calcification,cavitation,bronchial sign,lobar sign,burr sign and pleural adhesion sign in the two groups had no significant differences(P>0.05).The mean effective tubular bulb dose,length product of radiation dose,total tubular bulb dose,radiation volume dose index in the study group were higher than those in the control group:(46.15±7.38)mAs vs.(104.39±10.53)mAs,(169.24±19.77)mGy·cm vs.(427.17±43.58)mGy·cm,(972.65±58.34)mAs vs.(2861.26±181.37)mAs,(3.55±1.16)mGy vs.(8.95±2.07)mGy,there were statistical differences(P<0.05).The excellent,good,acceptable,poor of 1.0 mm image quality in the study group were 26,60,18,2,and in the control group were 32,64,8,0,there was statistical difference(u=1.71,P=0.087).The excellent,good,acceptable,poor of maximum intensity projection(MIP)image quality in the study group were 58,42,6,0 and in the control group were 7

关 键 词：肺结节 体层摄影术 X线计算机 辐射剂量 诊断 检出率 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]