低剂量CT联合迭代重建技术及三维重建技术在部分实性肺结节中的临床应用价值

The clinical value of low-dose CT combined with iterative reconstruction and threedimensional reconstruction in some solid pulmonary nodules

目的 探讨低剂量CT联合迭代重建技术及三维重建技术在部分实性肺结节患者随访中的临床应用价值.方法 回顾分析2017年6月至2018年6月经常规剂量CT扫描(120kVp滤波反投影算法,FBP)筛查出直径>6mm的部分实性肺结节患者53例,并在3~6个月后应用低剂量CT扫描(100kVp)进行随访,分别应用迭代重建算法(IMR)、FBP、FBP联合三维技术进行图像重建.采用主观及客观图像评价方法对图像质量进行评价.结果 主客观对图像质量进行分析均示低剂量联合IMR法具有较好的图像质量,低噪声,高SNR及CNR(P<0.05).低剂量联合IMR法的PS实性成分及磨玻璃成分的SNR及CNR值均较高(P<0.05).低剂量联合IMR可有效降低患者辐射剂量[(3.36±0.45) vs (2.03±0.37),P<0.05].另外,对图像进行三维重建后,病灶形态、分叶、毛刺、血管集束征及瘤肺界面的显示较常规轴位图像可提供更多的信息(P<0.01).结论 较常规剂量CT及常规低剂量CT扫描相比,低剂量CT联合IMR可降低图像噪声,且有效降低部分实性肺结节患者随访过程中的辐射剂量,三维重建技术可提供更多PS的特征信息,有望在外科手术决策中起到指导作用.

Objective To compare the diagnostic quality of reduced radiation dose computed tomography with iterative model reconstruction(IMR)versus that of conventional dose CT with filter back projection in patients with part-solid nodule.Methods 53 patients who had part-solid nodule more than 6mm in diameter in lung were included in this retrospective study in our hospital.Results The objective analysis of image quality showed that low-dose CT combined IMR method had good image quality,low noise,high SNR and CNR(P<0.05),and the SNR and CNR values of PS solid components and glass ground opaque components were higher(P<0.05).Low dose CT combined IMR can effectively reduce the radiation dose of patients(3.36±0.45 vs 2.03±0.37,P<0.05).Conclusion Compared with conventional dose CT and conventional low-dose CT,CT with IMR has effectively dose reduction in patients with sub-solid pulmonary nodule,reduces noise and improves depiction of targeted lesion.Additionally,the method of three-dimensional reconstruction is promising to be an key role of surgical decision.