低剂量多层螺旋CT在急腹症中的初步应用

The Primary Application of Low-dose Multi-slice CT in Acute Abdominal Disease

目的探讨低剂量多层螺旋CT(MSCT)扫描技术在急腹症中的应用价值。资料与方法对53例可疑急腹症患者行腹部KUB平片和腹部低剂量MSCT扫描,分析KUB平片和低剂量MSCT对急腹症诊断的敏感性、特异性和准确性,对比分析两种方法检查结果(χ2检验)。记录并比较低剂量与常规剂量的CT剂量指数(CTDI)。结果KUB阳性27例,阴性26例,其中30例与临床最后诊断相符,23例不符,检出率为56.60%,其敏感性为54.8%,特异性63.6%,准确性56.6%;低剂量MSCT扫描阳性41例,阴性12例,其中48例与临床最后诊断相符,5例不符,检出率为90.57%,其敏感性为88.9%,特异性87.5%,准确性88.7%。两种方法对急腹症的检出率有显著性差异(χ2=7.7,P<0.01)。本组低剂量与常规剂量扫描的CTDI平均值分别为4.8mGy和27.22mGy。结论低剂量MSCT较KUB平片敏感、准确,也是急腹症安全的影像学检查方法。

Objective To evaluate the value of low-dose multi-slice CT (MSCT) scanning technique in acute abdominal disease. Materials and Methods KUB plain film and low-dose MSCT scanning were performed in 53 cases with suspected acute abdominal disease, the sensitivity,specificity and accuracy of KUB plain film and low-dose MSCT scanning were calculated respectively, and a statistical analysis was made with chi-square test. CTDI(computed tomography dose index) of low-dose CT and standard-dose CT was recorded and compared. Results The number of positive and negative were 27 and 26 in KUB group , 30 of 53 cases were proved by clinic or surgery and 23 cases weren't. Agreement rate was 56.6%, the sensitivity, specificity and accuracy of KUB plain film were 54.8%, 63.6% and 56.7 % respectively . The number of positive and negative were 41 and 12 in low-dose MSCT group, 48 of 53 cases were proved by clinic or surgery and 5 cases weren't. Agreement rate was 90.57%, the sensitivity, specificity and accuracy of low-dose MSCT were 88.9% ,87.5% and 88.7 % respectively. There was a significant difference between two groups (χ~2=7.7,P<0.01). Comparing with standard-dose MSCT, CTDI of low-dose CT was reduced sharply (from 27.22 mGy to 4.8 mGy).Conclusion Low-dose MSCT is a sensitive, accurate and safe method for acute abdominal disease, it is better than KUB plain film.