胸部低剂量螺旋CT在健康人群中筛查肺结节的应用价值分析

Application value of chest low-dose spiral CT for screening pulmonary nodules in healthy population

目的比较胸部CT常规剂量扫描与低剂量扫描在健康人群中进行肺结节筛查的价值。方法对300例健康体检者肺部CT扫描进行分析,比较常规剂量扫描与低剂量扫描筛查肺结节的图像质量、检出率和辐射剂量。结果常规剂量组、低剂量组两组图像质量评分比较,差异无统计学意义(t=1.08,P>0.05),均能满足诊断要求。常规剂量组150例检出肺结节22例34个,病理证实早期肺癌2例;低剂量组150例检出肺结节19例30个,病理证实早期肺癌1例,两者在检出率比较,差异无统计学意义(χ2=1.61,P>0.05)。而辐射剂量方面,常规剂量组的剂量长度乘积、平均有效管球剂量、总管球剂量和放射容积剂量指数分别为(492.64±43.96)m Gy·cm、(110.22±9.76)m As、(3110.36±143.34)m As和(9.53±2.63)m Gy,低剂量组分别为(153.22±18.45)m Gy·cm、(42.58±3.43)m As、(978.45±40.87)m As和(3.53±1.73)m Gy,两组比较,差异均有统计学意义(t分别=7.78、6.52、10.44、8.16,P均<0.05)。结论胸部低剂量螺旋CT扫描对肺结节的显示及检出与常规剂量相同,辐射剂量更小,更适合健康群体中肺结节的筛查。

Objective To compare the value of conventional-dose chest CT scans and low-dose CT for screening lung nodules in healthy population. Methods The lung CT scan image of 300 healthy individuals were analyzed, and the im-age quality, detection rate and radiation dose between the conventional-dose group and the low-dose group were compared. Results The image quality that all could meet the diagnostic requirements between two groups was not statistical different （t=1.08,P〉0.05）. 34 pulmonary nodules of 22 cases were detected in the 150 cases of conventional-dose group, and 2 cases were histologically confirmed early stage lung cancer. 30 pulmonary nodules of 19 cases were detected in the 150 cases of low-dose group, and 1 case was histologically confirmed early lung cancer. The detection rate between the two groups was statistical different（χ2=1.61,P〉0.05）. In the conventional group, the dose length product, effective mAs, total mAs and CT dose index volume were （492.64±43.96） mGy·cm,（110.22±9.76） mAs,（3110.36±143.34） mAs and （9.53± 2.63）mGy respectively while in the low-dose group were （153.22±18.45） mGy·cm,（42.58±3.43） mAs,（978.45±40.87） mAs and （3.53±1.73） mGy. The differences between two groups were significant （t=7.78, 6.52, 10.44, 8.16,P〉0.05）. Conclusion The low-dose CT scan have same function with conventional dose in screening pulmonary nodules. Because of the lower radiation dose, it is more suitable for screening lung nodules in healthy population.