不同低剂量CT扫描方案对健康体检人群肺磨玻璃结节筛查及评估的影响  

Effects of different low-dose CT scanning protocols on the screening and evaluation of pulmonary ground-glass nodules in healthy physical examination subjects

作　　者：王迩诺 陈武飞 李铭 Wang Ernuo;Chen Wufei;Li Ming(Department of Computer Tomography,Huadong Hospital,Shanghai 200000,China)

机构地区：[1]华东医院CT室,上海200000

出　　处：《中华健康管理学杂志》2025年第3期207-212,共6页Chinese Journal of Health Management

基　　金：上海申康医院发展中心临床科技创新项目(SHDC22015025)。

摘　　要：目的评价不同低剂量CT扫描方案对健康体检人群肺磨玻璃结节筛查及评估的影响。方法本研究是前瞻性队列研究。纳入2016年3月至2021年12月在华东医院行肺部CT体检的全部805例健康体检者,采用美国GE公司生产的宝石能谱CT(HDCT)首次以管电流为50 mA(电压120 kV)检出41例有肺部磨玻璃结节者,并在3个月后以管电流为25 mA进行复查扫描,2次扫描的其他参数均保持一致。记录每次扫描的CT容积剂量指数(CTDIvol)和有效剂量(ED)。由2名放射诊断医师对每次扫描所见的肺部磨玻璃结节进行统计,以Wilcoxon配对符号秩和检验比较不同管电流(I)值扫描对磨玻璃结节的检出情况、图像诊断接受率及主观图像质量评分的差异。结果I=50 mA时,平均CTDIvol、ED分别为(3.71±0.35)mGy、(1.94±0.24)mSv;I=25 mA时,分别为(1.84±0.20)mGy、(0.97±0.11)mSv(均P<0.05)。采用I=25 mA的辐射剂量较I=50 mA下降了50%,并且I=25 mA时能检出在I=50 mA时发现的全部磨玻璃结节。I=25 mA时2名医师的肺窗、纵隔窗及骨窗平均图像诊断接受率评分分别为(4.77±0.42)、(4.62±0.49)、(4.81±0.39)分,平均主观噪声评分分别为(4.63±0.48)、(4.17±0.62)、(4.84±0.37)分,I=50 mA时为(4.82±0.39)、(4.78±0.42)、(4.84±0.37)分及(4.70±0.46)、(4.55±0.59)、(4.88±0.33)分(均P>0.05)。2名医师对肺部磨玻璃结节的检出、图像诊断接受率及主观噪声的评定结果Kappa值分别为1.000、0.706和0.885(均P<0.05)。结论不同低剂量CT扫描方案均能满足健康体检人群肺磨玻璃结节的筛查和诊断要求,但I=25 mA时的CT扫描方案辐射剂量更低。ObjectiveTo evaluate the effects of different low-dose CT scanning protocols on the screening and evaluation of pulmonary ground-glass nodules in healthy physical examination subjects.MethodsThe study was a prospective cohort study.A total of 805 healthy subjects who underwent pulmonary CT examinations at Huadong Hospital from March 2016 to December 2021 were included.The first examination was performed using the American GE Discovery CT750(HDCT),with a tube current of 50 mA(voltage 120 kV),and 41 subjects with pulmonary ground-glass nodules were identified.A follow-up examination was conducted three months later with a tube current of 25 mA,while all other parameters remained consistent.The CT volume dose index(CTDIvol)and effective dose(ED)were recorded for each scan.Two radiologists statistically analyzed the pulmonary ground-glass nodules observed in each scan.The Wilcoxon signed-rank test was used to compare the differences in the detection of ground-glass nodules,diagnostic image acceptance rate,and subjective image quality scores between the two different tube current(I)values.ResultsWhen I was 50 mA,the average CTDIvol and ED were(3.71±0.35)mGy and(1.94±0.24)mSv;When I was 25 mA,the average CTDIvol and ED were(1.84±0.20)mGy and(0.97±0.11)mSv(both P<0.05).Compared with the 50 mA,there was 50%intrinsic dose reduction when I was 25 mA.All the ground-glass nodules detected under the 50 mA circumstance were also detected when I was 25 mA.The diagnostic acceptability and image noise score with I of 25 mA were(4.77±0.42),(4.62±0.49),(4.81±0.39)and(4.63±0.48),(4.17±0.62),(4.84±0.37)and these were(4.82±0.39),(4.78±0.42),(4.84±0.37)and(4.70±0.46),(4.55±0.59),(4.88±0.33)(all P>0.05)with I of 50 mA.The Kappa values for the detection of pulmonary ground-glass nodules,diagnostic image acceptance rate,and subjective noise assessment by the two radiologists were 1.000,0.706,and 0.885,respectively(all P<0.05).ConclusionDifferent low-dose CT scanning protocols can meet the screening and diagnostic requireme

关 键 词：体层摄影扫描仪 X线计算机 辐射剂量 肺 磨玻璃结节 多排螺旋CT 低剂量 健康体检 

分 类 号：R73[医药卫生—肿瘤]