宝石CT低剂量扫描在麻疹肺炎影像诊断中的价值

THE USE OF GEMSTONE CT LOW-DOSE SCANNING IN DIAGNOSING PNEUMONIA WITH MEASLES IN CHILDREN

目的探讨宝石CT低剂量扫描在小儿麻疹肺炎影像诊断中的应用及价值。方法选取2013年11月至2016年12月间经临床确诊为麻疹肺炎的患儿51例为观察组,所有患儿均行宝石CT低剂量扫描。另随机选取小儿胸部疾患20例为对照组,给予常规剂量胸部CT平扫。计算两组有效剂量(ED),比较两组不同扫描剂量下的图像噪声、有效剂量(ED)以及对肺纹理、间质改变。根据Mayo等的评价标准进行分级评价,分析、评价两组不同剂量检查对于图像质量有无差异,总结麻疹肺炎的影像学特征。结果对照组图像噪声为(12.5±2.95)HU,观察组图像噪声为(13.02±1.56)HU,两组比较差异无统计学意义(P>0.05);两组图像均可清晰显示肺内血管、支气管、肺间质及微小病变,纵隔及周围组织结构显示清晰。对照组图像甲级40例,乙级5例,丙级5例,不合格0例。观察组图像甲级38例,乙级8例,丙级5例,不合格0例,两组比较差异无统计学意义(P>0.05);对照组有效剂量(ED)(8.03±0.41)mSv,观察组有效剂量(ED)(1.07±0.32)mSv,两组间有显著统计学意义(P<0.05)。麻疹肺炎CT表现为肺过度充气21例;支气管束增粗51例;间质网织结节影37例;气胸3例,皮下、纵隔气肿1例。结论宝石CT低剂量扫描较常规CT剂量明显降低,可以很好地观察麻疹肺炎肺过度充气和间质纹理增多、小结节影等主要表现,为麻疹肺炎的影像诊断提供了有利手段、方法。

Objective To explore the use of Gemstone CT low-dose in diagnosing pneumonia with measles in Children.Methods 51 cases of pneumonia with measles in Children in the observation group were treated in this hospital from November, 2013 to December, 2016, and all these cases underwent Gemstone CT low-dose scanning.Another 20 cases of thoracic disease in the control group got routine chest CT scanning.The effective dose（ED） of two groups was calculated.The image noise, the ED and the changes in lung markings and interstitial change in the two groups were compared.Mayo evaluation criterion was used to conduct classification evaluation, the image quality was compared between the two groups, and the imaging characteristics of pneumonia with measles were summed up.Results The image noise was（12.5±2.95）HU in the observation group and （13.02±1.56）HU in the control group （P〉0.05）.The blood vessels in lungs, bronchus,pulmonary interstitium, minimal lesions, mediastinum and surrounding tissues could be clearly shown on the images in both groups.The image quality of Grade A was found in 40 cases, of Grade B in 5 cases, of Grade C in 5 cases and of the unqualified in no cases were found in the control group, while the image quality of Grade A was found in 38 cases, of Grade B in 8 cases, of Grade C in 5 cases and of the unqualified in no cases were found in the observation group（P〉0.05）.The ED was （8.03±0.41）mSv in the control group and was（1.07±0.32）mSv in the observation （P〈0.05）.Pulmonary hyperinflation occurred in 21 cases, bronchial-vascular bundle thickening in 51 cases, interstitial nodular shadows in 37 cases, pneumothorax in 3 cases and mediastinal emphysema in 1 case.Conclusion Gemstone CT low-dose scanning can evidently decrease the radiation dosage than conventional CT scanning, can well display the main features of pulmonary hyperinflation, interstitial thickening and minor nodular shadows and can offer a useful method for the diagnosis of pneumonia with measles.