高分辨率低剂量胸部CT在健康体检中的应用价值

The application value of high-resolution low-dose chest CT in health screening

目的探讨高分辨率低剂量CT(HRLDCT)在无症状健康体检者筛查肺部疾病和肺外病变的应用价值。方法回顾性分析于2011年1月—2021年12月在广州市第一人民医院行胸部HRLDCT检查的1940例无症状健康体检者的影像学资料,由两位研究者分别评估和记录所有受检者的每一个阳性CT病征征象,分析各个阳性CT征象在总受检人群中的检出情况、各个阳性CT征象在性别、年龄分层中的分布情况,以及肺外阳性CT征象检出情况。比较肺癌和肺良性结节在不同性别、不同年龄段分布中的检出情况。结果共有1831例受检者存在阳性CT征象,总检出率为94.38%,共检出3339个阳性CT征象。检出率最高的阳性CT征象是肺部良性结节(1630例,84.02%)。在973例男性受检者中,检出肺癌22例(2.26%),肺良性结节815例(83.73%);在967例女性受检者中,检出肺癌19例(1.96%),肺良性结节815例(84.28%),肺癌与肺良性结节在不同性别间的检出率比较差异无统计学意义(P=0.64,χ^(2)=0.214)。肺部阳性CT征象的检出率随年龄的增长而升高,肺癌与肺良性结节最多见于51~60岁受检人群中,两者在51~60岁和61~70岁中的检出率比较差异有统计学意义(P=0.038,χ^(2)=4.32)。此外,检出最多的肺外其他阳性CT征象为脂肪肝,共497例(25.62%),其次是冠状动脉钙化173例(8.90%)。结论HRLDCT在胸部的健康体检中可同时用于肺部疾病的筛查及发现肺外异常征象,具有较高的临床应用价值。

Objective To investigate the application value of high-resolution low-dose CT(HRLDCT)in screening for lung diseases and extra-pulmonary lesions in asymptomatic healthy individuals.Methods A retrospective analysis was performed on the images of 1940 asymptomatic healthy individuals who underwent chest HRLDCT examination in our hospital from January 2011 to December 2021.Two investigators conducted independent evaluations and recordings of each positive CT sign in all individuals.An analysis of the detection rates of positive CT signs in the entire population,examining their distribution across various gender and age groups was involved in this study.The detection of positive CT signs outside the lung was also investigated.Additionally,the comparative analysis of lung cancer and benign pulmonary nodules detection across various genders and age cohorts were performed.Results A comprehensive count of 1831 individuals exhibited positive CT signs,resulting in an overall detection rate of 94.38%,with identifying a total of 3339 positive CT signs.The positive CT sign with the highest detection rate was benign pulmonary nodule(1630 cases,84.02%).In 973 male participants,22 cases of lung cancer were detected(2.26%),and 815 cases of benign lung nodules were found(83.73%).In 967 female participants,19 cases of lung cancer were detected(1.96%),and 815 cases of benign lung nodules were identified(84.28%).Statistical analysis revealed no significant difference in the detection rates of lung cancer and benign lung nodules between genders(P=0.64,χ^(2)=0.214).The prevalence of positive CT signs in the lungs demonstrates an upward trend with advancing age.Notably,individuals aged 51-60 exhibit a higher incidence of lung cancer and benign lung nodules.A statistically significant disparity in the detection rates of these conditions is observed between the 51-60 and 61-70 age cohorts(P=0.038,χ^(2)=4.32).In addition,the most frequently detected extrapulmonary positive CT findings were fatty liver,with a total of 497 cases(25.62%),followed by coronary artery calcification with 173 cases(8.90%).Conclusions HRLDCT can be effectively employed in the screening of pulmonary conditions and identification of extra-pulmonary abnormalities during thoracic health assessments,demonstrating considerable clinical significance.