低剂量CT扫描在肺结核诊断及病情监测中的应用价值

Application Value of Low-Dose CT in the Diagnosis and Monitoring of Pulmonary Tuberculosis

目的:探讨低剂量CT扫描对诊断肺结核及病情监测的价值。方法:回顾性分析2019年3月至2021年3月在我院进行治疗的357例疑似肺结核患者临床资料,均接受常规与低剂量扫描。比较两种剂量扫描对肺结核的诊断效能、影像学特征检出率、图像质量及辐射参数。结果:病理结果显示357例疑似肺结核患者最终确诊350例,低剂量扫描诊出低剂量扫描诊出342例,灵敏度为99.42%,特异度为33.33%,准确率为96.64%;常规剂量扫描诊出344例,灵敏度为99.71%,特异度为46.15%,准确率为97.76%,两种扫描方式诊断灵敏度、特异度及准确率差异无统计学意义(P>0.05)。两种扫描方式横断面、冠状面肺窗、纵隔窗图像质量得分差异无统计学意义(P>0.05);两种扫描方式对肺实变、磨玻璃密度影、钙化灶等影像学征象检出率差异无统计学意义(P>0.05)。低剂量扫描剂量长度乘积、容积CT剂量指数及有效剂量均明显低于常规剂量(P<0.05)。结论:较常规剂量,低剂量CT扫描在诊断效果、图像质量相当的情况下,可有效降低辐射剂量,能应用于肺结核诊断及病情监测。

Objective:To investigate the application value of low-dose CT in the diagnosis and monitoring of pulmonary tuberculosis.Methods:The clinical data of 357 patients who were suspected of pulmonary tuberculosis and treated in the hospital from March 2019 to March 2021 were analyzed retrospectively.All patients underwent conventional-dose and low-dose scanning.The diagnostic performance,detection rates of imaging features,image quality,and radiation parameters were compared between the two scanning methods.Results:Pathological results showed 350 patients with pulmonary tuberculosis,and 342 cases were diagnosed with low-dose scanning.The sensitivity,specificity and accuracy were 99.42%,33.33%and 96.64%.344 cases were diagnosed with conventional-dose scanning.The sensitivity,specificity and accuracy were 99.71%,46.15%and 97.76%.The diagnostic sensitivity,specificity,and accuracy of the two scanning methods were similar(P>0.05).The image quality scores of cross-sectional and coronal lung window and mediastinal window were close in terms of different scanning methods(P>0.05).The detection rates of imaging signs such as lung consolidation,ground-glass opacity and calcification by the two scanning methods were close(P>0.05).The dose-length product,volume CT dose index and effective dose of low-dose scanning were lower than those of conventional-dose scanning(P<0.05).Conclusion:Compared with conventional-dose CT scanning,low-dose CT scanning can effectively reduce radiation dose while achieving comparable diagnostic results and image quality.It can be used for the diagnosis and monitoring of pulmonary tuberculosis.