超低剂量CT引导下肺小结节术前带钩钢丝定位可行性的临床研究

Ultralow dose computed tomography protocol for hookwire localization of solitary pulmonary nodules prior to video-assisted thoracoscopic surgery

目的探讨超低剂量CT扫描方案(Sn100 kV)在肺小结节术前带钩钢丝定位术(hook-wire localization,HWL)中的可行性。方法选取88例术前HWL的患者,通过计算机随机分为标准剂量CT扫描方案组(A组:管电压110 kV,管电流50 mA,n=44)或超低剂量CT扫描方案组(B组:100 Sn kV和固定96 mA,n=44)。统计和比较两组间的定位成功率,并发症和辐射剂量。结果两组患者HWL定位的符合率均为100%。与A组相比,B组的CTDIvol值(P<0.001),总DLP值(P<0.001)和ED值(P<0.001)均明显减低。两组间并发症发生率差异无统计学意义(P>0.05)。结论超低剂量CT可以显著减低患者的有效辐射剂量,且不影响HWL的成功率和安全性,值得推广应用。

Objective This study prospectively investigated the feasibility of ultralow dose computed tomography(CT)-guided hook-wire localization(HWL)at 100 kV with tin filtration(100Sn kV)for small solitary pulmonary nodules.Methods Eighty-eight consecutive patients undergoing CT-guided HWL were randomly assigned to standard dose CT(Group A n=44;reference 110 kV and 50 mA)or ultralow dose CT(Group B n=44;100Sn kV and 96 mA)protocols.The technical success rate,complications and radiation dose were compared between the groups.Results The technical success rates were 100%for both groups.The mean volume CT dose index and total dose-length product were significantly lower in Group B compared to Group A(P<0.001).The effective dose in Group B was significantly lower than that in Group A(P<0.001).There were no significant differences in complication rates between the protocols(P>0.05).Conclusion Ultralow dose CT-guided HWL performed at 100 Sn kVp spectral shaping significantly reduce the radiation dose,with high technical success and acceptable patient safety.