16排螺旋CT低剂量胸部扫描在肺结核诊断中的应用价值

Application value of 16-slice spiral CT low dose chest scan in the diagnosis of pulmonary tuberculosis

目的探讨16排螺旋CT低剂量胸部扫描在肺结核诊断中的应用价值。方法选择2014年2月至2016年2月于我院就诊的40例肺结核患者,均接受常规胸部CT扫描及低剂量CT扫描,比较常规剂量与低剂量CT扫描辐射剂量的差异,比较常规剂量与低剂量CT扫描对肺结核病变特征的显示情况,包括病灶数目、毛刺、结节、空洞、实变、磨玻璃影、钙化及胸膜粘连。结果低剂量扫描CT剂量指数[(29.8±3.6)vs(43.2±6.3)]及剂量长度乘积[(34.3±4.2)m Gycm vs(138.7±27.6)m Gycm]均显著低于常规剂量,差异有统计学意义(P<0.05);两者诊断准确率分别为92.5%和87.5%,差异无统计学意义(P>0.05);与常规剂量CT扫描比较,低剂量CT扫描对病灶数目、结节、空洞、实变、钙化及胸膜粘连征象显示情况差异均无统计学意义(P>0.05),但低剂量CT扫描对毛刺(38.0%vs 51.1%)及磨玻璃影(36.4%vs 49.6%)的显示率低于常规剂量CT扫描,差异均具有统计学意义(P<0.05)。结论 16排螺旋CT低剂量胸部扫描能够显示肺结核病变特征,且具有辐射剂量低的优点。

Objective To explore the application value of 16-slice spiral CT low dose chest scan in the diagnosis of pulmonary tuberculosis. Methods Forty patients of pulmonary tuberculosis in our hospital from February 2014 to February 2016 were selected, which all underwent routine chest CT scan and low dose CT scan. The radiation dose were compared between routine CT scan and low dose CT scan, and the characteristics of pulmonary tuberculosis were also compared, including the number of lesions, burr, nodules, holes, real change, grinding glass shadow, calcification and pleu-ral adhesion. Results The CT dose index and dose length product of low dose burr were significantly lower than that of routine CT scan, （29.8±3.6） vs （43.2±6.3）, （34.3±4.2） mGycm vs （138.7±27.6） mGycm, P〈0.05. The diagnostic accuracy was 92.5% and 87.5%, respectively, and the difference was not statistically significant （P〉0.05）. Compared with routine CT scan, low dose CT scan showed no significant difference in the number of lesions, nodules, holes, real change, calcifi-cation and pleural adhesion signs （P〉0.05）, but it showed statistically significant difference in the display rate of the burr （38.0%vs 51.1%） and the grinding glass （36.4% vs 49.6%） （P〈0.05）. Conclusion 16-slice spiral CT low dose chest scan can show the characteristics of pulmonary tuberculosis, and has the advantage of low radiation dose.