螺旋CT胸部低剂量扫描在良恶性肺结节定性诊断中的临床意义  

Clinical Significance of Low-Dose Spiral CT Chest Scan in Qualitative Diagnosis of Benign and Malignant Pulmonary Nodules

作　　者：耿然 吴丙丙 胡凯 GENG Ran;WU Bingbing;HU Kai(Imaging Department,Luoyang First People's Hospital,Luoyang 471000,China)

机构地区：[1]洛阳市第一人民医院影像科,河南洛阳471000

出　　处：《临床医学工程》2025年第3期311-314,共4页Clinical Medicine & Engineering

摘　　要：目的 对比低剂量与常规剂量螺旋CT诊断肺结节良恶性的效能,以及二者在CT征象表现上的差异。方法 选取2023年1月至2024年9月我院收治的92例肺结节患者作为研究对象,均行螺旋CT常规剂量扫描、螺旋CT低剂量扫描。以病理结果为“金标准”,对比两种扫描方式诊断肺结节良恶性的效能。对比两种扫描方式检出恶性肺结节的CT征象以及形态。比较两种扫描方式的辐射剂量。结果 病理诊断显示,92例肺结节患者中良性结节49例,恶性结节43例;螺旋CT常规剂量扫描检出恶性50例,良性42例;螺旋CT低剂量扫描检出恶性49例,良性43例。螺旋CT低剂量扫描的灵敏度、特异度、准确度、阳性预测值、阴性预测值与螺旋CT常规剂量扫描相比,差异无统计学意义(P>0.05)。两种扫描方式检出的胸膜凹陷征、空泡征、分叶征、短毛刺征占比比较,差异无统计学意义(P>0.05)。两种扫描方式检出的部分实性结节、实性结节、纯磨玻璃样结节占比比较,差异无统计学意义(P>0.05)。螺旋CT低剂量扫描的CTDIvol、 DLP、 ED均显著低于螺旋CT常规剂量扫描(P <0.05)。结论 螺旋CT胸部低剂量扫描对于良恶性肺结节的诊断效能与常规剂量相当,但可降低辐射剂量,是更加安全的检查手段。Objective To compare the efficacy of low-dose and conventional dose spiral CT in diagnosing benign and malignant pulmonary nodules,as well as the differences in CT manifestations between the two methods.Methods A total of 92 patients with pulmonary nodules admitted to our hospital from January 2023 to September 2024 were selected as the research subjects,all of whom underwent conventional dose spiral CT scan and low-dose spiral CT scan.With the pathological results as the"gold standard",the efficacy of two scanning methods in diagnosing benign and malignant pulmonary nodules was compared.The CT signs and morphology of malignant pulmonary nodules detected by the two scanning methods were compared.The radiation doses of two scanning methods were compared.Results Among the 92 patients with pulmonary nodules,pathological diagnosis showed 49 benign nodules and 43 malignant nodules;Conventional dose spiral CT scan detected 50 cases of malignancy and 42 cases of benign;Low-dose spiral CT scan detected 49 cases of malignancy and 43 cases of benign.No statistically significant difference was found in the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value between low-dose spiral CT scan and conventional dose spiral CT scan(P>0.05).No statistically significant difference was found in the proportions of pleural indentation sign,vacuole sign,lobulation sign and short spiculation sign detected by the two scanning methods(P>0.05).No statistically significant difference was found in the proportions of partially solid nodules,solid nodules,and pure ground glass nodules detected by the two scanning methods(P>0.05).The CTDIvol,DLP,and ED of low-dose spiral CT scan were significantly lower than those of conventional spiral CT scan(P<0.05).Conclusions The diagnostic efficacy of low-dose spiral CT chest scan for benign and malignant pulmonary nodules is comparable to conventional dose,but it can reduce radiation dose,and is a safer examination method.

关 键 词：肺结节良恶性 螺旋CT 低剂量扫描 常规剂量扫描 CT征象 CT形态 辐射剂量 

分 类 号：R814.42[医药卫生—影像医学与核医学]