数字化断层融合技术对肺结节筛查应用的初步研究

Preliminary study of digital tomosynthesis for the screening of pulmonary nodules

目的：探讨数字化断层融合技术对肺结节的检出价值.方法：选取48例肺结节患者,先后分别行DR、断层融合（DTS）及CT检查.将CT检查结果作为判断肺结节的标准,另选择两位有3年以上工作经验的放射科医师,在已知每例患者CT所显示的结节位置后,分别观察胸片和数字断层融合图像上对相应部位结节的显示率,对结果进行x2检验.将结节依据直径大小分为3组（3～5 cm,5～10 cm和10～20 cm）后,对组与组之间的观察结果进行比较.结果：48例患者共发现结节59个,DR和DTS发现结节的敏感度分别为47.46%（28/59）和88.14%（52/59）,x2检验示差异有显著性意义（P〈0.01）,结节直径为5～10 mm组DTS较DR检出结节的敏感度最高.59个结节中,CT显示磨玻璃密度结节16个,其中,DTS可显示14个（14/16）,DR显示2个（2/16）,DTS较DR显示率明显高.结论：数字化断层融合较传统DR可显著提高肺结节的检出率,对磨玻璃密度结节的检出率较高.

Objective：To investigate the value of digital tomosynthesis （DTS） for the detection of pulmonary nodules. Methods：48 patients suspected of having pulmonary nodules underwent digital radiography （DR）, DTS and CT respectively. The results of CT were used as standard of reference. The chest DR,DTS were reviewed by three radiologists independ ently according to the knowledge obtained by CT to confirm the visibility as well as the location of pulmonary nodule. The results were analyzed by Chi square test. The detected nodules were divided into 3 groups according to their diameters （3- 5mm, 5-10mm, 10- 15mm） and the sensitivity of nodule detection by DR and DTS were compared by means of Chi-square test. Results：59 nodules were found in these 48 patients. The sensitivity of detecting nodules of DR and DTS were as 47.46% （28/59） and 88. 14% （52/59） respectively. Statistical significance hetween the two examinations were existed （P〈0.01）. The sensitivity of DTS was the highest compared with that of DR in detecting nodules with the diameter as 5- 10mm. Of the 59 pulmonary nodules,16 showed ground glass opacity on CT,14 could be seen on DTS and only 2 could be seen on DR images. The detectability of DTS was obviously higher than that of DR. Conclusion：Digital tomosyntinesis has significantly improved the detection rate over conventional DR, especially for the nodules with ground glass opacity.