数字化断层融合技术在肺结节筛查中的临床应用研究

目的比较常规数字X线摄影(DR)与数字化断层融合技术(DTS)对肺部结节的检出率。资料与方法搜集本院同时行DR和DTS检查,并经CT证实的肺部结节患者83例共125个病灶作为研究对象,以CT证实的肺结节数目作为相对金标准,按结节大小分为3组(0.5≤D<1.0 cm,1.0≤D<2.0 cm,2.0≤D≤3.0 cm),由3位高年资放射科医师独立阅片,分别观察三组之间在DR与DTS上对相应部位肺结节的检出率,并对结果进行χ2检验。结果结节直径在0.5≤D<1.0 cm及1.0≤D<2.0 cm范围内,肺结节显示率DTS优于DR,且二者之间的差异具有统计学意义(P<0.05);结节直径在2.0≤D≤3.0 cm范围内,DTS与DR对肺结节显示率相近,二者之间的差异不具有统计学意义。结论 DTS排除解剖结构重叠的干扰,提高对病变检出的敏感性,可作为DR及CT在肺部结节筛查工作中的补充检查手段及患者胸部较小结节病灶的主要随访观察手段,甚至是作为高危人群肺结节筛查的主要检查方法。

The Clinical Preliminary Research of Digital Tomosynthesis for the Screening of Pulmonary Nodules

Objective To compare the detection rate of lung nodules by conventional digital radiography(DR) and digital tomosynthesis(DTS).Materials and Methods 83 patients with 125 nodules checked by DR and DTS were collected,the number of lung nodules confirmed by CT were used as the relative gold standard,and nodules were divided into 3 groups according to diameter(0.5≤D<1.0 cm,1.0≤D<2.0 cm,2.0≤D≤3.0 cm),three high senior radiologists reviewed the films independently,and the detection rate of lung nodules were observed on DR and DTS among the three groups.The results were analyzed by McNemar test.Results DTS was better than DR on showing lung nodules of diameter in 0.5≤D<1.0 cm and 1.0≤D<2.0 cm,and the difference between them was statistically significant(P<0.05).The display rate of the pulmonary nodules of diameter in 2.0≤D≤3.0 cm on DTS was similar to that on DR,and the difference between them was no statistically significant.Conclusion Eliminated the interference of overlapping anatomical structures and enhanced the sensitivity of lesion detection,DTS can be used as a supplementary method for DR or CT in patients with small lung nodulars,even as the primary screening method in high risk group of lung nodules.