Contrast Study on the Application of Imaging Techniques in Detection of Ground Glass Lesion Using Phantom
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摘要: 目的：借助嵌有磨玻璃病灶的胸部体模研究X线摄影、计算机断层扫描（CT）和数字断层融合（DTS）3种检查技术在新型冠状病毒肺炎筛查中的应用价值。方法：将19枚与新型冠状病毒肺炎的典型影像表征相似的类椭圆形磨玻璃影磨玻璃病灶置入体模内各肺叶处，分别用低剂量CT扫描、DTS扫描和X线摄影方法检查，更换病灶位置后再次检查，对3种方法的总检出率、磨玻璃病灶所在胸壁位置、肺叶位置、大小等对各方法检出率的影响进行分析。结果：CT技术的总检出率高达100%，DTS技术（52.6%）次之，但与最低的DR技术（31.6%）之间的差异无统计学意义，两者与CT技术之间的差异均具有统计学意义；DTS技术对前后方向上胸侧壁处的病灶的检出率可达100%，而对胸前壁或后壁处的病灶均未能检出，对病灶大小（不小于2.21cm×1.55cm）的敏感度为62.5%，不如对前后方向上的位置（胸侧壁处）的敏感度（100%）；DR技术在此检出的最小病灶大小为4.86cm×4.5cm，其检出和未检出病灶的大小之间存在差异，对病灶大小（大于4cm×4cm）的敏感度（85.7%）高于对前后方向上的位置（胸侧壁处）的敏感度（60%）；DTS或DR技术对不同肺叶内的病灶的检出率不存在显著性差异；3种技术的平均有效辐射剂量当量值之间的差异均具有统计学意义，DR技术最低，为0.026mSv/次，CT技术（0.829mSv/次）比DTS技术（0.709mSv/次）稍高。结论：除病情严重、炎症范围较大、行动不便的新型冠状病毒肺炎患者可考虑采用DR技术进行检查外，其他情况下宜用体检用低剂量CT检查方法为首选方案。Abstract: Objective: To study the application value of radiography, computed tomography (CT) and digital tomosynthesis (DTS) in the screening of novel coronavirus pneumonia (NCP) with chest phantom embedded with ground glass shadow lesion. Methods: A total of 19 Patchy ellipsoid ground glass shadow lesions with image features similar to those of NCP were placed in the lung lobes of the phantom. Low-dose CT, DTS and radiography were respectively used in the inspection of the phantom. After the adjustment of the ground glass shadow lesions' position, the examinations were taken again. The respective detection rate of the three methods, the influence of the location of the chest wall, the location of the lung lobes and size of the ground glass shadow lesions on the detection rate were analyzed. Results: The overall detection rate of CT was 100%, followed by DTS (52.6%) and DR (31.6%), the latter two respectively had statistically significant difference with CT, but there was no statistically significant difference between them. The detection rate of DTS to the ground glass shadow lesions near the lateral chest wall was 100%, but 0 to the ones near the anterior/posterior chest wall. The sensitivity to the size (no less than 2.21cm×1.55cm) was 62.5%, which was not as good as the sensitivity to the anterior-posterior plane position (lateral chest wall) (100%). The minimum size of the ground glass shadow lesions detected by DR in the study was 4.86cm×4.53cm. There was a difference between the size of the ground glass shadow lesions detected and that not detected by DR. The sensitivity of DR to the ground glass shadow lesions size (larger than 4cm×4cm) was 85.7%, which was higher than that (60%) to the anterior-posterior plane position (lateral chest wall). And no significant difference between the detection rates to the ground glass shadow lesions in different lung lobes was found for DTS or DR. The difference of the mean effective dose equivalent values of the three methods was statistically significant. The lowest value was 0.026mSv/time of DR, and the CT was 0.829mSv/time, a little higher than 0.709mSv/time of DTS. Conclusion: Low-dose CT examination is the first choice for NCP patients, except those with severe illness, large inflammatory range and poor mobility, who should be examined by DR technique.
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Keywords:
- ground glass lesion /
- radiography /
- digital tomosynthesis /
- computed tomography
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