低剂量MSCT扫描诊断周围型肺癌的临床价值(1)
摘 要 目的：探讨周围型肺癌诊断中低剂量多层螺旋CT(MSCT)扫描的临床价值。方法：选取疑似周围型肺癌患者198例，按照随机数表法分为低剂量组和常规剂量组各99例。低剂量组采用低剂量MSCT检查，常规剂量组采用常规剂量MSCT检查，并均以病理诊断结果为标准，比较两组诊断结果及诊断价值。结果：两组周围型肺癌的组织分型比较；两组诊断周围型肺癌的准确性、敏感性、特异性、阴性预测值及阳性预测值比较；两组的血管集束征、空泡征、胸膜凹陷征、毛刺征及肿瘤分叶征的检出率比较，差异均无统计学意义(P>0.05)。结论：低剂量MSCT诊断周围型肺癌可满足临床诊断要求，易被临床接受。
关键词 周围型肺癌 低剂量 多层螺旋CT 常规剂量
中图分类号：R730.44； R734.2 文献标志码：A 文章编号：1006-1533(2019)23-0084-03
Clinical value of low-dose MSCT scan in the diagnosis of peripheral lung cancer
DAI Youfeng
(Department of Imaging， the People’s Hospital of Shangyou County， Jiangxi Ganzhou 341200， China)
ABSTRACT Objective： To investigate the clinical value of low-dose multi-slice spiral computed tomography (MSCT) scan in the diagnosis of peripheral lung cancer. Methods： One hundred and ninety-eight patients with suspected peripheral lung cancer were divided into a low-dose group and a routine-dose group with 99 cases each according to random number table， in which the former was given low-dose MSCT examination and the later routine-dose MSCT examination. The diagnostic results and diagnostic value were compared between the two groups by taking pathological diagnosis results as the standard. Results： There were no statistical differences between two groups in the tissue typing of peripheral lung cancer， the diagnostic accuracy， sensitivity， specificity， negative predictive value and positive predictive value and the detection rate of vessel convergence sign， vocule sign， pleural indentation sign， spicule sign and tumor lobulation sign (P>0.05). Conclusion： Low-dose MSCT for the diagnosis of peripheral lung cancer can meet the diagnostic requirements and is easily accepted by the clinic.
KEy WORDS peripheral lung cancer； low-dose； multi-slice spiral CT； routine-dose
周圍型肺癌是一种常见的恶性肿瘤，多由吸烟、电离辐射、既往肺部慢性感染等多种因素引起，易产生胸痛、发热等症状，多于中晚期被确诊，延误最佳治疗时机，影响患者预后[1-2]。多层螺旋CT(MSCT)是诊断周围型肺癌的常用方法，具有扫描速度快、图像后处理功能强大等特点。常规剂量MSCT检查1次所受的辐射剂量相当于200～400张胸片的剂量，而高辐射剂量易促使白血病和癌症等疾病的发生风险增加[3]。因此，在保证CT图像质量的前提下应尽可能减少辐射剂量。临床检查中，在其他参数不变的情况下降低管电流是减少辐射剂量的最直接方法，但降低MSCT检查时的管电流，将明显增加图像造影，产生伪影，对低对比分辨率造成影响[4-5]。
1 资料与方法
1.1 一般资料
选取2015年4月—2018年12月在江西省赣州市上犹县人民医院就诊的疑似周围型肺癌患者198例，按照随机数表法分为低剂量组和常规剂量组各99例。低剂量组男63例，女36例；年龄41～75岁，平均(57.63±9.78)岁；病史：呼吸道感染史32例，肺结核史16例，慢性支气管史27例，吸烟史64例；结节直径0.7～4.5 cm，平均(2.78±0.72)cm。常规剂量组男60例，女39例；年龄41～76岁，平均(57.65±9.79)岁；病史：呼吸道感染史30例，肺结核史19例，慢性支气管史28例，吸烟史67例；结节直径0.8～4.5 cm，平均(2.79±0.75)cm。两组一般资料比较，差异无统计学意义(P>0.05)，具可比性。入选者及其家属均签署知情同意书。, 百拇医药(戴犹峰)
关键词 周围型肺癌 低剂量 多层螺旋CT 常规剂量
中图分类号：R730.44； R734.2 文献标志码：A 文章编号：1006-1533(2019)23-0084-03
Clinical value of low-dose MSCT scan in the diagnosis of peripheral lung cancer
DAI Youfeng
(Department of Imaging， the People’s Hospital of Shangyou County， Jiangxi Ganzhou 341200， China)
ABSTRACT Objective： To investigate the clinical value of low-dose multi-slice spiral computed tomography (MSCT) scan in the diagnosis of peripheral lung cancer. Methods： One hundred and ninety-eight patients with suspected peripheral lung cancer were divided into a low-dose group and a routine-dose group with 99 cases each according to random number table， in which the former was given low-dose MSCT examination and the later routine-dose MSCT examination. The diagnostic results and diagnostic value were compared between the two groups by taking pathological diagnosis results as the standard. Results： There were no statistical differences between two groups in the tissue typing of peripheral lung cancer， the diagnostic accuracy， sensitivity， specificity， negative predictive value and positive predictive value and the detection rate of vessel convergence sign， vocule sign， pleural indentation sign， spicule sign and tumor lobulation sign (P>0.05). Conclusion： Low-dose MSCT for the diagnosis of peripheral lung cancer can meet the diagnostic requirements and is easily accepted by the clinic.
KEy WORDS peripheral lung cancer； low-dose； multi-slice spiral CT； routine-dose
周圍型肺癌是一种常见的恶性肿瘤，多由吸烟、电离辐射、既往肺部慢性感染等多种因素引起，易产生胸痛、发热等症状，多于中晚期被确诊，延误最佳治疗时机，影响患者预后[1-2]。多层螺旋CT(MSCT)是诊断周围型肺癌的常用方法，具有扫描速度快、图像后处理功能强大等特点。常规剂量MSCT检查1次所受的辐射剂量相当于200～400张胸片的剂量，而高辐射剂量易促使白血病和癌症等疾病的发生风险增加[3]。因此，在保证CT图像质量的前提下应尽可能减少辐射剂量。临床检查中，在其他参数不变的情况下降低管电流是减少辐射剂量的最直接方法，但降低MSCT检查时的管电流，将明显增加图像造影，产生伪影，对低对比分辨率造成影响[4-5]。
1 资料与方法
1.1 一般资料
选取2015年4月—2018年12月在江西省赣州市上犹县人民医院就诊的疑似周围型肺癌患者198例，按照随机数表法分为低剂量组和常规剂量组各99例。低剂量组男63例，女36例；年龄41～75岁，平均(57.63±9.78)岁；病史：呼吸道感染史32例，肺结核史16例，慢性支气管史27例，吸烟史64例；结节直径0.7～4.5 cm，平均(2.78±0.72)cm。常规剂量组男60例，女39例；年龄41～76岁，平均(57.65±9.79)岁；病史：呼吸道感染史30例，肺结核史19例，慢性支气管史28例，吸烟史67例；结节直径0.8～4.5 cm，平均(2.79±0.75)cm。两组一般资料比较，差异无统计学意义(P>0.05)，具可比性。入选者及其家属均签署知情同意书。, 百拇医药(戴犹峰)