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目的探讨不同剂量多层螺旋计算机断层扫描(MSCT)胸部扫描对尘肺病的筛查效果。方法采用随机抽样方法,抽取40名粉尘作业工人,分别采用常规剂量(管电压130 k V,管电流25.0~75.0 m As)与方案1(管电压110 k V,管电流50 m As)、方案2(管电压110 k V,管电流16.0 m As)、方案3(管电压80 k V,管电流16.0 m As)的低剂量扫描,分别对轴位1.5 mm薄层高分辨率重建、5.0 mm普通层厚高分辨率重建和5.0 mm厚层冠状位最大密度投影的重建图像进行对比分析。结果方案1和方案2的图像质量得分和低剂量MSCT图像评价得分均优于方案3(P<0.01)。方案1和方案2的图像对40名研究对象的p、q、s和t小阴影均能显示;除方案2对t小阴影显示的得分外,方案1和方案2的图像对4种小阴影显示的得分分别与常规剂量组比较,差异均无统计学意义(P>0.02)。方案3的图像对4种小阴影的显示明显减少,伪影较多;该方案的图像对p、q和t小阴影显示的得分均低于常规剂量组(P<0.01)。评价MSCT辐射剂量的指标容积CT剂量指数、加权CT剂量指数、剂量长度乘积和平均有效剂量,在4种MSCT方案中从高到低均呈常规剂量组>方案1组>方案2组>方案3组的趋势(P<0.05)。结论低剂量MSCT方案可满足对尘肺病筛查的需要;采用管电压110 KV及管电流16 m As的方案在获得较好质量图像的同时,有利于降低筛查者接受的辐射量。
Objective To investigate the screening results of pneumoconiosis with different doses of multi-slice spiral computed tomography (MSCT) chest scan. Methods A total of 40 dust-exposed workers were sampled by random sampling method. The routine dose (tube voltage 130 k V, tube current 25.0-75.0 m As) and scheme 1 (tube voltage 110 k V, tube current 50 m As) 2 (tube voltage of 110 kV, tube current of 16.0 m As) and protocol 3 (tube voltage of 80 kV and tube current of 16.0 mAs) The reconstructed images of ordinary layer thickness and high resolution reconstruction and 5.0 mm thick coronal maximum density projection were compared and analyzed. Results The scores of image quality and low-dose MSCT images of protocol 1 and protocol 2 were better than that of protocol 3 (P <0.01). The images of Scenario 1 and Scenario 2 displayed small p, q, s, and t shades for all 40 subjects; the Scenario 1 and Scenario 2 images were superior to the others for 4 small The scores of shading showed no significant difference compared with the conventional dose group (P> 0.02). The images of Scheme 3 showed a significant reduction in the display of the four small shadows with more artifacts. The images of the scheme showed lower scores for the small shadows of p, q and t than those of the conventional dose group (P <0.01). The indexes of MSCT radiation dose volume, volume CT dose index, weighted CT dose index, dose length product and average effective dose were all from high to low in all four MSCT regimens> regimen 1> regimen 2> regimen 3 Group trend (P <0.05). Conclusion The low-dose MSCT regimen can meet the need of screening for pneumoconiosis. Using 110 kV tube voltage and 16 m As tube current can reduce the amount of radiation accepted by the screeners while obtaining good quality images.