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目的 探讨64排128层螺旋CT低剂量扫描技术对于肺结核患者病情监测的应用价值.方法 对我院120例经临床确诊的成人活动性继发性肺结核患者(痰涂片结核杆菌阳性)行64排CT检查,在其他扫描条件一致情况下分别采用常规120 mA及15～40 mA低剂量扫描,采用盲法阅片,记录每次扫描的CT容积剂量指数(CTDIvol)以及剂量长度乘积(DLP),根据有效剂量转换因子(K=0.014)估算每次CT检查所致有效剂量(ED),对比低剂量和常规剂量扫描和薄层重建的特殊影像表现,进行定量测量及差异分析.结果 两种扫描方式对于实变、支气管扩张、空洞、磨玻璃密度影、钙化灶、树芽征、结节、胸膜肥厚、胸水等结核基本征象显示无明显差异,低剂量扫描受检者所受的X射线辐射剂量显著下降.结论 飞利浦64排螺旋CT低剂量扫描技术和常规剂量相比,在保障检测效果的情况下,辐射剂量大幅度下降,可应用于肺结核的临床诊断及随访.“,”Objective To investigate the application value of 64-row 128-slice spiral CT low-dose scanning technique in monitoring the condition of pulmonary tuberculosis.Methods The 120 pulmonary tuberculosis patients diagnosed in our hospital were collected. Routine dose (120 mA) and the following Low-dose (15～40 mA) scanning were used with the same tube voltage of 120 Kv and other factors. Read a slice in a blind manner to record CT dose Index volume (CTDIvol) and dose-length product (DLP). Effective dose (ED) was estimated according to effective dose conversion factor. The special imaging manifestations of low-dose and conventional dose scanning and thin-layer reconstruction were compared for quantitative measurement and difference analysis.Results There was no significant difference between the two scanning methods in terms of the basic signs of tuberculosis, such as consolidation, bronchiectasis, cavitation, ground-class opacity, calcification, tree-in-bud sign, nodule, pleural hypertrophy and hydrothorax. The X-ray radiation dose received by the subjects in low-dose scanning decreased significantly. Conclusion Compared with the conventional dose, the low-dose scanning technique of PHILIPS 64-slice spiral CT can significantly reduce the radiation dose under the condition of guaranteeing the detection effect, which can be applied to the clinical diagnosis and follow-up of pulmonary tuberculosis.