呼气相低剂量扫描可用于慢性阻塞性肺疾病患者双气相定量分析  

Low-dose expiratory CT can be used with dual-gas quantitative analysis in patients with chronic obstructive pulmonary disease

作　　者：常荷 马光明 于楠 田骞 CHANG He;MA Guangming;YU Nan;TIAN Qian(Department of Medical Imaging,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712046,China;School of Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]陕西中医药大学附属医院影像科,陕西咸阳712046 [2]陕西中医药大学医学技术学院,陕西咸阳712046

出　　处：《分子影像学杂志》2025年第4期419-423,共5页Journal of Molecular Imaging

基　　金：陕西省重点研发计划项目(2021ZDLSF04-10);秦创原中医药产业创新聚集区项目(L2024-QCY-ZYYJJQ-X134)。

摘　　要：目的通过降低慢性阻塞性肺疾病(COPD)患者双气相扫描过程中呼气相的辐射剂量,探讨呼气相低剂量扫查方案用于双气相定量CT诊断COPD和定量分析的应用价值。方法前瞻性纳入2023年10月~2024年3月在陕西中医药大学附属医院经临床肺功能检查确诊的67例COPD患者。采用常规辐射剂量[噪声指数(NI)=14]进行第1次呼气相和吸气相扫描,第2次呼气相采用低辐射剂量方案(NI=28)扫描,均采用60%ASIR重建。测量图像脂肪组织、肌肉组织、主动脉的CT值及SD值,并计算信噪比。将常规剂量组与低剂量组CT薄层重建图像导入“数字肺”数据分析平台并进行双气相配准,测量定量参数肺容积、肺气肿体积、肺气肿百分比、小气道病变区域体积、小气道病变区域百分比、呼气相低于-910 HU的低衰减区的像素体积占全肺体积的百分比、吸气相低于-950 HU的低衰减区的像素体积占全肺体积的百分比。比较低剂量组与常规剂量组间扫描剂量、定量CT参数以及图像主观评分。结果呼气相低剂量组扫描剂量较常规剂量组扫描剂量低(P<0.05);两组间双气相配准参数差异无统计学意义(P>0.05);低剂量呼气相组的图像SD值大于常规剂量呼气相组(P<0.05);低剂量呼气相图像评分与常规剂量呼气相图像评分差异无统计学意义(P>0.05)。结论双气相扫描定量评估COPD患者时,呼气相扫描使用低剂量扫描方案,能够保证定量CT评估结果与常规剂量一致,在满足评估需要的同时显著减低患者所接受的辐射剂量。Objective To explore the application value of low-dose expiratory phase scanning scheme in dual-gas phase quantitative CT diagnosis of chronic obstructive pulmonary disease(COPD)and qantitative analysis by reducing the radiation dose of expiratory phase during dual-gas phase scanning.Methods Sixty-seven patients with COPD confirmed by clinical pulmonary function tests at Affiliated Hospital of Shaanxi University of Chinese Medicine from October 2023 to March 2024 were prospectively included.The first expiratory and inspiratory phase scans were performed with a standard radiation dose(NI=14)and the second expiratory phase was scanned with a low radiation dose(NI=28).Both CT examinations used 60%ASIR.The CT value and the SD value of adipose tissue,muscle tissue and aorta were measured,and signal noise ratio were calculated.The thin-slice reconstruction images from the standard-dose group and the low-dose group were imported into the"Digital Lung"data analysis platform for dual-phase matching,and quantitative parameters were measured(lung volume,emphysema volume,Emph%,functional-small airways volume,fSAD%,LAA-910%,LAA-950%).The radiation dose,quantitative CT parameters and image subjective score were compared between low-dose group and standard-dose group.Results The radiation dose of the expiratory low-dose group was lower than that of standard-dose group(P<0.05).There was no significant difference in the two-gas phase registration parameters between the low-dose group and the standard-dose groups(P>0.05).The SD value in the expiratory phase of the low-dose group was greater than that in the standard-dose group(P<0.05).There was no significant difference in the ratings between the two groups(P>0.05).Conclusion The use of a low-dose scanning protocol for expiratory-phase scanning in the quantitative evaluation of COPD patients by dual-phase scanning ensures that the quantitative CT evaluation results are consistent with the standard-dose,meeting the needs of the evaluation while significantly reducing the radiation

关 键 词：低剂量 CT定量分析 慢性阻塞性肺疾病 双气相CT 

分 类 号：R563[医药卫生—呼吸系统]