低剂量CT影像引导下肺部肿瘤微创治疗的研究

目的探讨低剂量CT影像引导下肺部肿瘤微创治疗的可行性。方法采用随机对照试验设计,将符合纳入标准的160例肺部肿瘤的患者随机分配到对照组与试验组,分别使用不同辐射剂量的CT影像引导下微创治疗肺部肿瘤;记录不同剂量CT引导下肿瘤影像学特性、肿块大小、微创治疗肺部肿瘤的术中并发症(出血、气胸)影像学表现、CT剂量加权指数(CTDIvol)、扫描层数、剂量长度乘积Dose-Length Product(DLP)以及近期疗效等参数进行定量测量与差异性评价。结果表明试验组在降低毫安值,减少辐射剂量的同时,会产生一定噪声与伪影使到图像质量下降;但是两组CT影像引导下微创治疗肺部肿瘤过程的图像质量评价差异无统计学意义,显示试验组能达到对照组临床CT影像引导下肺部肿瘤微创治疗的要求。在扫描管电流剂量降低至15mA引导扫描时候,CT剂量加权指数(CTDIvol)从常规的17.95 mGy降低至2.26 mGy,降低幅度达87.41%。对照组CT下引导肺部肿瘤扫描的剂量长度乘积(DLP)远远大于试验组,试验组DLP值仅为对照组的35%。结论低剂量CT影像引导下肺部肿瘤微创治疗的方法,大大减低了患者辐射剂量,并可确保微创手术顺利实施的整个过程,本研究最低选用管电流15 mA CT引导技术值得同行借鉴与推广。

LOW DOSE CT IMAGE-GUIDED MINIMALLY INVASIVE THERAPY OF LUNG CANCER

Objective To investigate the low dose CT image-guided lung tumor the feasibility of minimally invasive treatment. Methods A randomized controlled trial design,will meet the inclusion criteria in 160 patients with lung cancer patients were randomly assigned to a control group and experimental group,using different radiation dose of CT imaging guided minimally invasive treatment of lung tumor;records of different doses of CT guided tumor imaging characteristics,tumor size,minimally invasive treatment of lung tumor during operation complications(bleeding,pneumothorax) imaging,CT dose index(CTDIvol),scanning layers,the dose length product Dose-Length Product(DLP) and curative effect in the near future and other parameters for quantitative measurement and evaluation of difference; ResultsThe results showed that the experimental group in reducing Ma value,reducing the radiation dose at the same time,will generate some noise and artifact image to image quality;but the two group of CT image guided minimally invasive treatment of lung tumor process image quality evaluation of the differences were not statistically significant,display the test group can achieve the control group in clinical CT imaging guided minimally invasive treatment for lung cancer.In the scanning tube current dose reduced to 15mA boot scan time,dosage of CT weighted index(CTDIvol) from the conventional 17.95 mGy to 2.26 mGy,reduce the rate of 87.41%.The control group CT guided lung tumor scan dose length product(DLP) is far greater than the experimental group,the test group DLP value is only 35% in the control group. Conclusion low dose CT image-guided lung tumor minimally invasive treatment methods,greatly reduce the patient radiation dose,and can ensure the smooth implementation of minimally invasive operation of the whole process,the study of the lowest selection of tube current 15mA CT guided techniques deserving reference and promotion.