低剂量CT扫描在儿童副鼻窦炎诊断中的应用

Application of Low-dose CT Scan in Diagnosis of Paranasal Sinusitis in Children

目的:探讨低剂量CT诊断儿童副鼻窦炎的影像表现与临床价值,以期在保证本病CT诊断效果的同时减少辐射剂量,提高儿童诊断安全性。方法:择取2018年1月-2019年10月67例接受CT检查的副鼻窦炎患儿,随机分为两组。试验组34例,予以患儿低剂量CT扫描;对照组33例,予以患儿常规剂量CT扫描。统计两组辐射剂量,比较观察两组副鼻窦炎影像显示情况,评价图像质量。结果:试验组CT扫描辐射剂量参数CTDIvol(6.75±2.11)mGy,低于对照组(13.24±5.36)mGy,DLP(52.18±16.75)mGy·cm,低于对照组(122.30±41.29)mGy·cm,差异有统计学意义(P<0.05)。试验组CT图像质量评价(9.1±0.7)分,与对照组(9.8±0.1)分比较,差异无统计学意义(P>0.05)。试验组CT影像表现:鼻窦黏膜增厚肿胀18例(52.94%),窦腔内软组织密度影10例(29.41%),分泌物潴留气液平面9例(26.47%),单纯囊肿6例(17.65%),合并腺样体肥大11例(32.35%)、鼻中隔偏曲7例(20.59%)、鼻腔息肉5例(14.71%),鼻窦窦壁骨质硬化增厚2例(5.88%)。结论:低剂量CT扫描对副鼻窦图像质量影响不大,以此诊断儿童副鼻窦炎基本可以获得与常规剂量CT扫描相当的诊断效果,但患儿所受辐射剂量明显减低,对保障儿童疾病诊疗安全具有积极作用。

Objective:To investigate the imaging manifestations and clinical value of low-dose CT in the diagnosis of paranasal sinusitis in children,in order to reduce the radiation dose and improve the diagnosis safety of children while ensuring the CT diagnosis of the disease.Methods:From January 2018 to October 2019,67 children with parasinusitis who underwent CT examination were selected and randomly divided into two groups.Thirty-four patients in the test group were given low-dose CT scans;33 patients in the control group were given regular-dose CT scans.The radiation doses of the two groups were counted,and the image display of paranasal sinusitis was compared between the two groups to evaluate the image quality.Results:The radiation dose parameter CTDIvol(6.75±2.11)mGy of the CT scan in the experimental group was lower than the control group(13.24±5.36)mGy,and the DLP(52.18±16.75)mGy·cm was lower than the control group(122.30±41.29)mGy·cm.The difference was statistically significant(P<0.05).The CT image quality evaluation score of the test group was(9.1±0.7).Compared with the control group(9.8±0.1),the difference was not statistically significant(P>0.05).CT images of the experimental group:18 cases(52.94%)of thickened and swollen sinus mucosa,10 cases(29.41%)of soft tissue density in the sinus cavity,9 cases(26.47%)of retained gas and liquid level of secretions,6 cases of simple cysts(17.65%),Combined with adenoid hypertrophy in 11 cases(32.35%),nasal septum deviation in 7 cases(20.59%),nasal polyps in 5 cases(14.71%),and sinus wall thickening in 2 cases(5.88%).Conclusion:Low-dose CT scan has little effect on the image quality of paranasal sinuses.Diagnosing paranasal sinusitis in children can basically obtain the diagnostic effect comparable to conventional CT scans,but the radiation dose received by children is significantly reduced,which is helpful for the safety of diagnosis and treatment of chidren’s diseases.