【摘要】 目的探讨低剂量螺旋CT扫描在检出肺段水平的支气管扩张(支扩)中的价值,评估其影像效果。方法(1)对40例临床诊断为支扩者进行检查。每位受检者均先行胸部常规剂量CT扫描,并对部分肺段进行低剂量CT扫描和HRCT扫描;(2)根据诊断的把握度将各肺段有否支扩用肯定是支扩、不能确定和肯定不是支扩进行评判。(3)图像质量评价:由2名CT医生按正常图像、图像有少许伪影、图像有严重伪影的等级对低剂量CT图像进行评判。结果(1)40例患者共430个肺段进行了低剂量CT和HRCT扫描。(2)经Kappa法检验,低剂量CT和HRCT两种方法在发现和诊断支扩中具有良好的一致性(Kappa值0.77)。以HRCT发现和诊断的支扩为标准,低剂量CT对支扩的敏感度91%、阳性预测值94%、准确度96%。(3)低剂量CT图像噪声水平增加,但98%以上图像可满足诊断需要。结论低剂量螺旋CT扫描在检出肺段水平的支扩中具有很高的价值,有望提高支扩的早期发现。它的正确应用可以有效地保护病人和保证图像质量。有条件者可开展低剂量CT筛查支扩。更多还原

【Abstract】 Objective To explore the detection value of bronchiectasis at segmental level and evaluate the imaging quality of low-dose spiral CT scanning.Methods (1) 40 cases with doubted by clinical evaluation were selected,and performed low-dose CT and HRCT scanning after having perform standard-dose CT scanning examination.(2)Bronchiectasis were explored by diagnostic confidence ("definite bronchiectasis","questionable bronchiectasis",and "definite not bronchiectasis").(3)CT images were evaluated by two doctors using blind method,and analyzed 3 degrees including normal image,image with few artifact,and image with excessive artifact.Results (1)40 cases (430 segments) were examined by using with low-dose CT and HRCT scanning.(2)The group of low-dose CT had a good coincidence with HRCT group by Kappa test (the Kappa values was 0.77).The sensitivity of low-dose CT group was 91%,the positive predictive value was 94%,the correction rate was 96%.(3)Low-dose CT scanning of the noise level were more higher,but 98% low-dose CT image was full readable.Conclusion Low-dose CT scanning have very high diagnostic values of bronchiectasis at segmental level and is expected to improve early detection of bronchiectasis.It may protect the patients and guarantee the imaging quality with proper employment.Low-dose CT scanning for bronchiectasis may be applied if situation permits.更多还原