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目的 分析低剂量多层螺旋CT(MSCT)全肺薄层扫描筛查早期肺癌的可行性,以提高其实际应用价值。方法 选择肺癌高危人群(≥50岁,吸烟总量≥20年包)387例行胸片及低剂量MSCT全肺薄层( 2. 5 ~3. 75mm)扫描检查,分析胸片和低剂量MSCT检出中央型和周围型肺癌的敏感性与特异性,分析低剂量MSCT扫描参数、权重CT剂量指数(CTDIW )和剂量长度乘积(DLP),评价该扫描技术的可靠性与安全性。结果 胸片检出周围型肺癌2例,中央型肺癌1例,敏感性分别为33. 3%、20. 0%,特异性分别为99. 2%、99. 2%。低剂量MSCT检出周围型肺癌5例,中央型肺癌4例,敏感性为83. 3% 、80. 0% ,特异性为94. 2%、96. 9%,CTDIW 和DLP分别为1. 63mGy和47. 1mGy·cm,约为常规剂量的6%和7%。结论 低剂量MSCT全肺薄层扫描是一种敏感、安全、可行的筛查早期(特别是早期中央型)肺癌的方法,能取代胸片筛查早期肺癌。
Objective To analyze the feasibility of low-dose multi-slice spiral CT (MSCT) whole lung thin-slice scanning screening of early lung cancer in order to enhance its practical value. Methods 387 routine chest radiographs and low-dose MSCT (2. 5 ~ 3. 75mm) thin-section scanning were performed on high-risk lung cancer patients (≥50 years, total smoking ≥20 years package) The sensitivity and specificity of the detection of central and peripheral lung cancer were detected. The low-dose MSCT scan parameters, the weighted CT dose index (CTDIW) and the dose length product (DLP) were analyzed to evaluate the reliability and safety of this scan technique. 2%, 99.2%. The results of chest radiography detected peripheral lung cancer in 2 cases, central lung cancer in 1 case, the sensitivity was 33.3%, 20.0%, specificity were 99.2%, 99.2%. Low-dose MSCT detection of peripheral lung cancer in 5 cases, 4 cases of central lung cancer, the sensitivity was 83.3%, 80.0%, specificity 94.2%, 96.9%, CTDIW and DLP were 1. 63mGy and 47. 1mGy · cm, about 6% and 7% of the conventional dose. Conclusion Low-dose MSCT pneumonectomy is a sensitive, safe and feasible method for screening early stage lung cancer, especially early stage central lung cancer. It can replace chest radiography in screening early stage lung cancer.