16排螺旋CT胸部低剂量扫描在肺结核诊断中的运用

目的对西门子16排螺旋CT胸部常规扫描及低剂量扫描的肺结核病例进行影像诊断对比分析,并与GE 64排螺旋CT胸部扫描肺结核病例进行对比,探讨低剂量扫描在肺结核诊断中的重要性,低剂量扫描可以在不影响疾病诊断的前提下明显降低辐射剂量,避免了因射线可能导致癌症的风险,从而达到绿色环保扫描。方法搜集西门子16排螺旋CT胸部常规扫描及低剂量扫描的结核患者80例,GE 64排螺旋CT胸部扫描结核患者40例,其中部分做了DR平片检查,经几位高年资医生从3方面进行对比分析:(1)不告知高剂量扫描或低剂量扫描的前提下分析图像的清晰度,分析图像诊断的准确性,进而统计在满足诊断的前提下,高低剂量胸部扫描各自所占比例。(2)对GE 64排螺旋CT胸部扫描满足诊断要求的40例肺结核病例与西门子16排螺旋CT低剂量扫描进行参数对比。(3)对比DR平片与CT扫描检查结果。结果 120例肺结核患者CT片均能达到诊断要求,肺内病变均能清晰显示,112例纵隔内血管间隙或淋巴结清晰显示,仅8例血管间隙或淋巴结边缘显模糊,但不影响诊断,其中常规扫描2例,低剂量扫描6例。120例中做了DR平片检查患者42例,12例CT片显示出DR平片未能明确显示的空洞,15例显示出DR平片未能显示的继发性支气管扩张。结论西门子16排螺旋CT胸部低剂量扫描在肺结核诊断中在诊断准确的前提下,辐射剂量明显降低,可作为肺结核的常规筛查及治疗复查。

Objective To explore the advantages and importance of low-dose scanning in the diagnosis of tuberculosis, Siemens 16-slice spiral CT TB cases routine chest CT scans and low-dose scans were analyzed contrast, and the GE 64-slice spiral CT our hospital cases were part of the chest scan contrast too. Low-dose scans can signiifcantly reduce radiation dose without impacting disease diagnosis to avoid the risk of radiation can cause cancer, so as to achieve the green scan. Methods Collected our hospital Siemens 16-slice spiral CT TB cases routine chest CT scans 80 cases （2012-1-12） of low-dose scan, chest scan GE 64-slice spiral CT TB cases 40 cases, some of which did DR examination by experienced radiologists several three-pronged approach comparative analysis. First, unknown the high-dose or low-dose CT scans under the premise of image sharpness, image analysis of the accuracy of the diagnosis. Further statistics on the premise of meeting the diagnosis of low-dose chest scan their proportion. Second, Parameters comparison between GE 64-slice spiral CT chest scan meet the diagnostic requirements of 40 cases of tuberculosis cases and Siemens 16-slice spiral CT scan low-dose contrast. Third, Contrast DR and CT scan results. Results 120 cases of tuberculosis diagnostic CT slices can meet the requirements of patients, lung lesions can be clearly showed that the 112 cases of meditational lymph vascular space or clear display, only eight cases of blood vessels or lymph node clearance signiifcantly blurred edges, but does not affect the diagnosis, which conventional scanning two cases, low-dose scan six cases. DR examination done 42 patients, comparative analysis of CT slice, 12 slice CT slice showing empty DR not clearly shown, 15 cases showed DR iflm failed to show secondary bronchiectasis. Conclusion Siemens 16-slice spiral CT low-dose chest scan in the diagnosis of tuberculosis can reduce the radiation dose signiifcantly ensuring the diagnostic accuracy, so as a routine screening and treatment of tuberculosis review.