改变体位联合 CT 靶扫描对特殊部位肺结节的诊断价值

目的：探讨改变体位联合C T靶扫描技术在特殊部位肺结节诊断中的价值。方法对22例行常规胸部C T扫描发现的位于心脏旁和后肋膈角的肺结节患者，增加改变体位及CT 靶扫描，记录2种扫描方法所得的图像的信噪比（SNR）和对比信噪比（CNR），从肺野充气膨胀程度、伪影严重程度、肺血坠积效应3方面主观评价图像质量，对比分析2种扫描方法对病灶CT征象的显示情况，评价医师对肺结节的诊断信心度，并进行统计学分析。结果与常规胸部CT 扫描靶重建相比，改变体位靶扫描的图像质量主观评分提高（P＜0．01），图像的SNR和CNR增加（P＜0．05），对病灶CT征象显示情况得分提高（P＜0．05），诊断信心度增加（P＜0．01）。结论改变体位联合CT靶扫描技术可以使结节征象显示更清楚，应作为心脏旁和后肋膈角肺结节的最佳扫描方法。

Diagnostic value of CT target scanning combining with changing position for pulmonary nodule in special location

Objective To evaluate the diagnostic value of CT target scanning combining with changing position for pulmonary nodules in special location .Methods CT target scanning combining with changing position was performed in 22 patients with pulmo‐nary nodules adjacent to heart or in posterior costophrenic angle ,which were found with routine spiral CT scanning .For objective analysis , the signal‐noise‐ratio (SNR) and contrast‐noise‐ratio (CNR) of lung were calculated .In terms of subjective assessment ,the image quality was rated on a 3‐point scale (0-2) for pulmonary inflation ,gravity‐dependent pulmonary perfusion and severity of artifacts , respectively .The CT features of pulmonary nodules were compared between different scanning techniques .Moreover ,the diagnostic confidence for pulmonary nodules was evaluated .The paired t test ,Wilcoxon signed‐rank test and Kappa test were used for statisti‐cal analysis .Results In comparison with conventional spiral CT scanning ,CT target scanning combining with changing position im‐proved the subjective image quality scores (P<0 .01) ,increased the signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio (CNR) , showed more detailed CT features (P<0 .05) ,and improved the confidence of diagnosis (P<0 .01) .Conclusion CT target scanning combining with changing position technique can show detailed features ,which should be recommended as the optimal scanning tech‐nique for pulmonary nodules adjacent to heart or in posterior costophrenic angle .