个体化低剂量CT诊断继发性肺结核的价值

The value of individual low-dose CT in the diagnosis of secondary pulmonary tuberculosis

目的:探讨个体化低剂量螺旋CT诊断继发性肺结核的价值。方法:随机选取人继发性肺结核病人,初次以常规剂量100 mAs检查,短期复查时根据病人体质量指数(BMI)将病人体型分为瘦、中等、肥胖三种,分别应用30 mAs、40 mAs、50 mAs扫描。以常规剂量100 mAs为对照,比较常规剂量与低剂量组胸壁肌肉、肺部CT值、噪声(SD)大小及结核病灶的影像学征象。结果:常规剂量组CT容积剂量指数11.2 m Gy,剂量长度乘积(363.16±36.09)m Gy·cm,均明显高于低剂量组的(14.90±0.78)m Gy、(159.41±30.22)m Gy·cm(P<0.01)。2组病人胸壁肌肉和肺的CT值、SD值差异均无统计学意义(P>0.05)。低剂量组胸壁肌肉SD值与常规剂量组比较明显增高(P<0.01)。2组病人树芽征、肺实变及磨玻璃、结节、条索、网状、空洞、纵隔淋巴结、胸膜增厚粘连、胸腔积液、钙化病变的图像差异均无统计学意义(P>0.05)。结论:BMI指导的低剂量螺旋CT诊断继发性结核有重要临床价值,可应用于临床。

Objective：The purpose of this study was to explore the value of low-dose spiral CT scanning in the diagnosis of secondary pulmonary tuberculosis. Methods：A total of 50 adult patients with secondary pulmonary tuberculosis were randomly selected from August to October in our hospital. Patients were initially examined with a conventional dose of 100 mAs. According to the Body Mass Index （BMI）,the patients were divided into thin,medium,obese three kinds of patients,respectively,the application of 30 mAs,40 mAs,50 mAs review. Compared with conventional dose 100 mAs, The low dose group was the test group, Comparison of chest wall muscle,lung CT value,noise（ SD） size. Compare the iconography-signs showed of the two groups Patients. Results：Conventional dose group CT volume dose index （CTDIvol） was 11. 2 mGy,dose-length product（DLP）was（363. 16 ＆#177; 36. 09）mGy＆#183;cm. Low dose group CTDI was（14. 90 ＆#177; 0. 78）mGy,DLP was（159. 41 ＆#177; 30. 22）mGy＆#183;cm,the difference was statistically significant（P〈0. 05）. There was no significant difference in the CT and SD values between the two groups of patients with chest wall（P〉0. 05）. The SD value of chest wall muscle in low dose group was significantly higher than that in conventional dose group, and the difference was statistically significant（P〈0. 05）. There was no significant difference in the two groups of patients with tree bud syndrome,lung real change and grinding glass,nodules,strips,mesh,cavity,mediastinal lymph nodes,pleural thickening and adhesion,pleural effusion,calcification lesions（P 〉 0. 05）. Conclusions：There was enormous clinical value of Low-dose CT in the diagnosis of secondary pulmonary tuberculosis ,and it should be used in clinic.