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目的建立一套适合于尘肺病筛查的多层螺旋CT(MSCT)低剂量扫描方案。方法将30例受检者同时做MSCT常规剂量扫描(130 kV,25～75 mAs)与方案1(110 kV,16 mAs)、方案2(80 kV,16 mAs)的低剂量扫描,对不同层厚重建图像、多平面重建(MPR)、最大密度投影(MIP)的图像质量与尘肺病病变的显示等方面进行对比分析。结果方案1的图像质量基本能满足诊断需要,对30例受检者的肺部小阴影均能显示,与常规剂量扫描的诊断结果一致。方案2的低剂量扫描图像质量差,伪影较多,对p、s型小阴影基本不能显示,30例中仅13例受检者(43.3%)可显示小阴影,与常规剂量扫描显示的小阴影比较,差异有统计学意义(P<0.01),不能满足尘肺病筛查需要。结论 MSCT用于尘肺病筛查的胸部低剂量扫描方案以受检者接受的辐射剂量为常规剂量的1/3～1/6为宜,肺窗图像采用高分辨率薄层和常规5～10 mm层厚2种方式重建,并辅以薄层的MPR与厚度为5～10 mm的冠状位MIP为好。
Objective To establish a multislice spiral CT (MSCT) low-dose scanning scheme suitable for pneumoconiosis screening. Methods Thirty subjects underwent low-dose scanning of MSCT conventional dose scanning (130 kV, 25-75 mAs) and Scenario 1 (110 kV, 16 mAs) and Scenario 2 (80 kV, 16 mAs) Thick reconstructed images, multiplanar reconstruction (MPR), maximum density projection (MIP) image quality and the display of pneumoconiosis lesions and other aspects of comparative analysis. Results The image quality of protocol 1 basically met the need of diagnosis. The small lungs of 30 subjects could be displayed, consistent with the diagnostic results of routine dose scanning. The poor quality of low-dose scanning images of scheme 2 and the large number of artifacts revealed that small shadows of p and s could not be displayed. Only 13 of the 30 cases (43.3%) showed small shadows. Compared with the conventional dose scanning Small shadow comparison, the difference was statistically significant (P <0.01), can not meet the needs of screening for pneumoconiosis. Conclusion The low-dose chest CT scan with MSCT for pneumoconiosis screening is suitable for the patients to receive radiation doses of 1/3 to 1/6 of the conventional dose. The pulmonary window images are made with high-resolution thin layers and conventional 5-10 mm thick layer reconstruction in 2 ways, supplemented by a thin layer of MPR and the thickness of 5 ~ 10 mm coronal MIP is better.