Abstract:Objective: To investigate the application value of low-dose CT in the diagnosis and monitoring of pulmonary tuberculosis. Methods: The clinical data of 357 patients who were suspected of pulmonary tuberculosis and treated in the hospital from March 2019 to March 2021 were analyzed retrospectively. All patients underwent conventional-dose and low-dose scanning. The diagnostic performance, detection rates of imaging features, image quality, and radiation parameters were compared between the two scanning methods. Results: Pathological results showed 350 patients with pulmonary tuberculosis, and 342 cases were diagnosed with low-dose scanning. The sensitivity, specificity and accuracy were 99.42%, 33.33% and 96.64%. 344 cases were diagnosed with conventional-dose scanning. The sensitivity, specificity and accuracy were 99.71%, 46.15% and 97.76%. The diagnostic sensitivity, specificity, and accuracy of the two scanning methods were similar (P>0.05). The image quality scores of cross-sectional and coronal lung window and mediastinal window were close in terms of different scanning methods (P>0.05). The detection rates of imaging signs such as lung consolidation, ground-glass opacity and calcification by the two scanning methods were close (P>0.05). The dose-length product, volume CT dose index and effective dose of low-dose scanning were lower than those of conventional-dose scanning (P<0.05). Conclusion: Compared with conventional-dose CT scanning, low-dose CT scanning can effectively reduce radiation dose while achieving comparable diagnostic results and image quality. It can be used for the diagnosis and monitoring of pulmonary tuberculosis.
王立, 高瑜, 王志永, 陈晓辉, 杨朝怡曹雷, 梁矿立, 张志飞, 李永波, 赵玺. 低剂量CT扫描在肺结核诊断及病情监测中的应用价值[J]. 河北医学, 2023, 29(9): 1527-1531.
WANG Li, GAO Yu, WANG Zhiyong, et al. Application Value of Low-Dose CT in the Diagnosis and Monitoring of Pulmonary Tuberculosis. HeBei Med, 2023, 29(9): 1527-1531.
[1] 刘裔,韩红洋.联合检测TB、PPD及TB-Ab在活动性肺结核中的临床意义[J].川北医学院学报,2020,35(5):907-910. [2] 颜小艳,徐亮,彭世秀,等.低剂量螺旋CT扫描在早期肺癌诊断中的应用价值[J].海南医学,2018,29(7):969-971. [3] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等.肺结核基层诊疗指南(2018年)[J].中华全科医师杂志,2019,18(8):709-717 [4] 王秋萍.结核病影像诊断学教程[M].西安:西安交通大学出版社,2018.213-215. [5] 徐健,宋伟,李明利,等.胸部低剂量CT与常规剂量CT三维图像质量的比较[J].中国医学科学院学报,2006,28(1):53-57. [6] 唐威,黄遥,吴宁,等.64层螺旋CT胸部低剂量扫描方案优选的多中心研究[J].中华放射学杂志,2011,45(2):142-148. [7] Mayo JR,Hartman TE,Lee KS,et al.CT of the chest:minimal tube current required for good image quality with the least radiation dose[J].AJR Am Roentgenol,1995,164(3):603-607. [8] Natarajan A,Beena PM,Devnikar AV,et al.A systemic review on tuberculosis[J].Indian Tuberc,2020,67(3):295-311. [9] 赛军强,潘小磊.64排螺旋CT低剂量扫描结合T-SPOT试验对肺结核的诊断价值[J].社区医学杂志,2022,20(4):202-206. [10] Martini K,Loubet A,Bankier A,et al.Nodular reverse halo sign in active pulmonary tuberculosis:a rare CT feature[J].Diagn Interv Imaging,2020,101(5):281-287. [11] 尹丹萍,李理,李淑燕.低剂量CT在继发性肺结核诊断中的应用价值[J].解放军预防医学杂志,2018,36(8):1086-1087,1091. [12] 张云轩,张鹤,信亚周,等.螺旋CT低剂量扫描对肺结核病情监测的应用价值[J].中国辐射卫生,2019,28(1):95-97.