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目的研究低剂量多排螺旋CT在诊断活动性肺结核中的应用,以减少患者的辐射剂量。方法选择2012年1月至2015年1月在宁夏回族自治区固原市人民医院就诊,临床上有咳嗽、咯痰、咯血等呼吸道症状1~3月,X线胸片发现有结核病灶的40例门诊患者为研究对象,男性27例,女性13例,年龄为30~78岁,平均(54.0±1.0)岁。使用Brilliance 16排多层螺旋CT扫描机(美国菲利浦公司)对每位肺结核患者连续进行较高剂量多层面CT检查和低剂量多层面CT检查,电压均为120 k V,电流分别为200和30~50 m As。对不同剂量的CT图像质量和辐射剂量进行比较。结果高剂量(管电压120 k V,管电流200 m As)与低剂量(管电压120 k V,管电流30~50 m As)CT扫描图像质量比较无显著差异,均能满足诊断要求。高剂量组与低剂量组CT加权剂量指数(CTDIw)平均值分别为11.8 m Gy和2.9 m Gy。低剂量组累积辐射剂量[(63.5±23.2)m Gy·cm]低于高剂量组[(249.0±20.7)m Gy·cm],差异有统计学意义(P<0.01)。结论采用低剂量扫描技术可减少对患者的照射剂量,能达到诊断要求,且低剂量扫描可延长球管的使用寿命。
Objective To study the application of low-dose multi-slice spiral CT in the diagnosis of active pulmonary tuberculosis in order to reduce the radiation dose of patients. Methods January 2012 to January 2015 in Ningxia Hui Autonomous Region People’s Hospital of Guyuan City, clinically cough, expectoration, hemoptysis and other respiratory symptoms 1 to 3 months, chest X-ray found 40 cases of tuberculosis clinic Patients were studied in 27 cases of males and 13 females, aged from 30 to 78 years, with an average of (54.0 ± 1.0) years. Each patient with pulmonary tuberculosis was continuously treated with a high-dose multi-slice CT scan and a low dose multi-slice CT scan using a Brilliance 16-slice multi-slice spiral CT scanner (Philips USA) at 120 kV and currents of 200 And 30 to 50 m As. Different doses of CT image quality and radiation dose comparison. Results There was no significant difference in the quality of CT images between high dose (tube voltage 120 kV, tube current 200 m As) and low dose (tube voltage 120 k V, tube current 30-50 m As), which could meet the diagnostic requirements. The average CT-weighted dose index (CTDIw) for the high-dose and low-dose groups was 11.8 m Gy and 2.9 m Gy, respectively. The cumulative dose of radiation in low dose group [(63.5 ± 23.2) m Gy · cm] was lower than that in high dose group (249.0 ± 20.7 mGy · cm) (P <0.01). Conclusions The low-dose scanning technique can reduce the radiation dose to the patient and meet the diagnostic requirements. The low-dose scanning can prolong the service life of the bulb.