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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。
Objective To investigate the value of low-dose spiral CT in the detection of bronchiectasis at the level of lung segments and to evaluate the imaging results. Methods (1) 40 cases of clinical diagnosis of dilatation were examined. Each subject had chest CT scan and low-dose CT scan and HRCT scan of some of the lung segments. (2) According to the degree of diagnosis, To determine and certainly not support the expansion of judgments. (3) Evaluation of image quality: Low-dose CT images were judged by two CT doctors according to the level of normal images, a little image artifacts and serious artifacts of images. Results (1) A total of 430 pulmonary segments of 40 patients underwent low-dose CT and HRCT scans. (2) The Kappa test showed that low-dose CT and HRCT had good agreement (Kappa value 0.77) in detecting and diagnosing branch expansion. With HRCT findings and diagnosis of the expansion as the standard, low-dose CT 91% of the branch expansion, the positive predictive value of 94%, accuracy of 96%. (3) The noise level of low dose CT images increases, but more than 98% of the images can meet the needs of diagnosis. Conclusion Low-dose helical CT scan is of great value in the detection of bronchiectasis at the level of the lung segment, and is expected to improve the early detection of dilation and extension. Its proper application can effectively protect the patient and ensure the image quality. Conditions can carry out low-dose CT screening expansion.