容积数据高分辨率CT重组在弥漫性肺疾病中的应用

Application of thin-reconstruction of volumetric data with a high-resolution CT algorithm in patients with diffuse lung diseases

目的评价CT容积数据高分辨率重组图像在弥漫性肺疾病中的应用价值.方法对56例表现为肺弥漫性病变的病例和9例采用Heitzman法进行固定、干燥的肺标本进行多层螺旋CT(MSCT)、高分辨率CT(HRCT)扫描和容积数据HRCT重组.比较所获得的容积数据HRCT重组图像和HRCT扫描图像并进行分级评分.结果容积数据HRCT重组图像和HRCT扫描图像对9例尸体肺标本和56例弥漫性肺疾病的评价是一致的.容积数据HRCT重组图像和HRCT扫描图像在评价肺标本的小叶核心结构的得分分别为51分和53分,两者在显示小叶间隔线的得分相同,都为53分,差异均无统计学意义(P值分别为0.157、1.000).56例弥漫性肺疾病容积数据HRCT重组图像和HRCT扫描图像的质量总分值分别为6～17、7～19,两者差异无统计学意义(P=0.094).HRCT单独扫描增加96%的辐射量,延长扫描时间.结论容积数据HRCT重组图像评价弥漫性肺病的价值与HRCT扫描图像相同.容积数据HRCT重组图像缩短检查时间、降低辐射量、方法简单易行,值得广泛推广使用.

Objective To evaluate the clinical application of thin-reconstruction of volumetric data with a high-resolution algorithm in diffuse lung diseases. Methods Fifty-six patients who had been diagnosed or suspected with diffuse lung diseases and 9 entire lung specimens that were obtained at autopsy and inflated and fixed by Heitzman＇s method underwent MSCT and HRCT scans and volumetric HRCT reconstructions. Conventional HRCT scans and volumetric HRCT images were rated for image quality and diagnostic value in diffuse lung diseases. Radiation dose and scan time were calculated. Results No significant difference was found in the identification of CT findings of diffuse lung diseases and entire lung specimens between conventional HRCT scans and volumetric HRCT images. Total score values of volumetric HRCT and conventional HRCT techniques in the depiction of the centrilobular region and interlobular septa in the lung specimens were 51 vs 53, and 53 vs 53, respectively. Total score values of volumetric HRCT and conventional HRCT techniques in the evaluation of patients with diffuse lung diseases were 6 - 17 and 7 - 19, respectively, P = 0. 094. Conventional HRCT scans increased 96% radiation dose in theory and lenghtened the examination time. Conclusion The present investigation demonstrates that routine-dose volumetric HRCT images allow a diagnostic approach to diffuse lung diseases as precise as that provided with conventional HRCT scans. But volumetric HRCT shortened the examination time and decreased the radiation dose.