ISSN 1004-4140
CN 11-3017/P
张明霞, 王仁贵. 超高分辨率薄层CT对直径2cm以下肺小结节诊断价值的初步研究[J]. CT理论与应用研究, 2014, 23(1): 123-130.
引用本文: 张明霞, 王仁贵. 超高分辨率薄层CT对直径2cm以下肺小结节诊断价值的初步研究[J]. CT理论与应用研究, 2014, 23(1): 123-130.
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ZHANG Ming-xia, WANG Ren-gui. Preliminary Study of Diagnostic Value of Ultra High Resolution Thin Slice CT on Small Pulmonary Nodules Diameter Less Than 2cm[J]. CT Theory and Applications, 2014, 23(1): 123-130.
Citation: ZHANG Ming-xia, WANG Ren-gui. Preliminary Study of Diagnostic Value of Ultra High Resolution Thin Slice CT on Small Pulmonary Nodules Diameter Less Than 2cm[J]. CT Theory and Applications, 2014, 23(1): 123-130.
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超高分辨率薄层CT对直径2cm以下肺小结节诊断价值的初步研究

Preliminary Study of Diagnostic Value of Ultra High Resolution Thin Slice CT on Small Pulmonary Nodules Diameter Less Than 2cm

    摘要
  • 摘要: 目的:孤立肺结节(SPN)的形态学特征是判断其良恶性的重要依据,CT成像的分辨率高低是提高SPN细微形态学特征显示率的关键因素。本研究的目的就是比较常规高分辨率薄层CT(512×512矩阵,HRCT)与超高分辨率薄层CT(1 024×1 024矩阵,ultra-HRCT)对直径≤2 cm肺小结节的几项细微形态学特征的显示是否存在差异,分析HRCT与ultra-HRCT成像在显示病变特征、图像质量及影响因素等方面的优劣性。方法:分别对人活体内72枚直径在2 cm以下的肺小结节进行HRCT及ultra-HRCT扫描成像。比较SPN的形态学指标包括:结节边缘,分叶(深、浅),晕征(清晰、模糊),毛刺(细短毛刺、细长毛刺、棘征);内部征象(空泡征、细支气管充气征、空洞),结节密度(钙化、磨玻璃密度)等。对HRCT和ultra-HRCT的图像质量及其影响因素进行主观评分,比较二者图像质量有无差异。同时对ultra-HRCT增加的X线辐射剂量进行分析。结果:对ultra-HRCT和HRCT成像对SPN的几项形态学指标的检出率比较后提示ultra-HRCT在显示边缘毛刺、空泡征等方面优于HRCT,但卡方检验P值均>0.05,没有统计学意义。二者图像质量主观评分HRCT图像质量优于ultra-HRCT,ultra-HRCT运动伪影和噪声发生率较HRCT高,二者差异卡方检验P值>0.05没有统计学意义。同时ultra-HRCT检查可增加X线辐射剂量,总体剂量在安全范围内。结论:ultra-HRCT对直径≤2 cm SPN的几项特征检出率均不低于HRCT,对边缘分叶、毛刺、晕征、空泡征、空气支气管征、GGO检出率均高于HRCT,提示ultra-HRCT在显示边缘分叶、毛刺、晕征、空泡征、空气支气管征、GGO等细微结构方面优于HRCT,但二者不存在显著统计学差异。图像质量主观评分HRCT高于ultra-HRCT;ultra-HRCT图像显示病变边缘及血管结构质量优于HRCT,运动伪影和噪声发生率较HRCT高,二者差异没有统计学意义。二者的X线辐射剂量均在安全范围内。

     

    Abstract: Objective:Morphological features of solitary pulmonary nodules is an important basis to judge the malignant and benign,high resolution CT imaging is a key factor to improve the detection rate of SPN subtle morphological characteristics.The objective of this study is to comparatively analyze the difference of pulmonary nodules diameter less than 2 cm imaging features between high resolution thin slice CT(512×512 matrix,HRCT) and ultra- high resolution thin slice CT(1 024×1 024 matrix,ultra-HRCT),and to analyze the advantages and disadvantages of ultra-HRCT in showing the fine structure of SPN and the image quality.Method:72 SPN in living body were scanned by ultra-HRCT and HRCT.The occurrence rate of various features of SPN was calculated,the features of SPN include:edge:lobulated sign(deep,shallow),halo sign(clear,fuzzy),burr sign(thin and short burr,thin and long burr,spine sign),internal structure(bubble sign/air bronchogram/cavity),nodules density(calcification,ground glass density).Meanwhile the image quality of ultra-HRCT and HRCT was observed,and their statistical difference was analyzed.Results:The occurrence rate of various features of SPN prompts that ultra-HRCT is better than HRCT,but P>0.05,which showed no significant statistically difference.The image quality of ultra-HRCT is better than that of HRCT,but P>0.05,which showed no significant statistically difference.Conclusions:The occurrence rate of various features of SPN on ultra-HRCT is less than that on HRCT,ultra-HRCT on the lobulated sign,burr sign,halo sign,bubble sign,air bronchogram,the detection rate of GGO is higher than that of HRCT,suggesting that ultra-HRCT in displaying the lobulated sign,burr sign,halo sign,bubble sign,air bronchogram,GGO and other fine is better than HRCT in terms of structure,but the two has no significant statistical difference.Subjective image quality score of HRCT was higher than Ultra-HRCT,ultra-HRCT image display quality is better than that of the edge of the lesion and vascular structure of HRCT,but the motion artifacts and noise occurrence rate is higher,the difference was not statistically significant.X-ray radiation dose of the two are in a safe range.

     

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