低剂量胸部CT检查对胸部肿瘤性病变的检出和诊断效果评价

Evaluation of the detection and diagnostic efficacy of low-dose chest CT examination for thoracic tumor lesions

目的探讨低剂量胸部CT检查对胸部肿瘤性病变的检出率和诊断价值。方法选取2000例胸部肿瘤患者随机均分为A、B两组,A组1000例使用常规剂量胸部CT扫描,B组1000例使用低剂量胸部CT扫描。结合患者的临床和影像学资料,对照评价低剂量胸部CT检查的图像质量、疾病检出率和良恶性肺结节诊断的准确率。结果与常规剂量相比,低剂量胸部CT检查总辐射剂量降低了60.23%。主观图像质量:纵隔窗质量略有下降,差异有统计学意义(P=0.001),肺窗和骨窗的图像质量差异无统计学意义(P=0.753和0.501);疾病检出率:对肺部小结节,胸腺结节、甲状腺结节、淋巴瘤、胸壁肿物、肾脏和肾上腺结节的检出率差异无统计学意义(P=0.294、0.743、0.530、0.616、0.459、0.339和0.125);对肺部小结节中癌前病变、早期肺癌的诊断准确率差异无统计学意义(P=0.345和0.648);对胸部良性病变和未定性病变诊断比较差异有统计学意义(P=0.001和*0.037)。结论低剂量胸部CT检查辐射剂量较常规CT检查大幅度降低,图像质量可以满足诊断要求,对多种胸部肿瘤性疾病的检出率及肺结节的良恶性诊断差异无统计学意义,但对部分良性和未定性病变的诊断准确率略有不足。

Objective To investigate the detection rate and diagnostic value of low-dose chest CT scans for thoracic tumor le⁃sions.Methods A prospective study randomly assigned 2000 patients into two groups,A and B,with 1000 patients in each group.Group A underwent conventional-dose chest CT scans,while Group B underwent low-dose chest CT scans.Combining clinical and radiological data,the image quality,disease detection rate,and accuracy of diagnosing benign and malignant pulmo⁃nary nodules were evaluated and compared between the two groups.Results Compared with conventional dose,the total radia⁃tion dose of low-dose chest CT scans decreased by 60.23%.Subjective image quality:there was a slight decrease in the quality of the mediastinal window,with statistically significant differences(P=0.001);however,there were no statistically significant dif⁃ferences in the image quality of lung and bone windows(P=0.753 and 0.501,respectively).Disease detection rate:there were no statistically significant differences in the detection rates of pulmonary nodules,thymic nodules,thyroid nodules,lymphoma,chest wall masses,kidney,and adrenal nodules(P=0.294,0.743,0.530,0.616,0.459,0.339,and 0.125,respectively);there were no statistically significant differences in the accuracy of diagnosing pre-cancerous lesions and early lung cancer among pulmonary nodules (P=0.345 and 0.648, respectively);however, there were statistically significant differences in diagnosing be⁃ nign and indeterminate lesions (P=0.001 and 0.037, respectively). Conclusion Low-dose chest CT scans significantly reduce radiation dose compared to conventional CT scans while maintaining image quality sufficient for diagnosis. There are no signifi⁃ cant statistical differences in the detection rates of various thoracic tumor diseases and the benign/malignant diagnosis of pulmo⁃ nary nodules. However, there is a slight decrease in the accuracy of diagnosing some benign and indeterminate lesions.