CAJ | 학술논문

目的：研究低剂量 CT 扫描在获得性免疫缺陷综合症（AIDS）合并卡氏肺孢子菌肺炎（PCP）正常体质量111例患者的临床应用，评价其可行性，并建立相应的扫描方案。方法使用美国通用电气（GE）公司 FII 双排螺旋 CT 机，其管电压值固定为120 kV ，分别采用常规扫描（自动调制 mAs）与低剂量扫描，低剂量扫描随机分为50 mAs 组（所用管电流为50 mAs）、40 mAs组（所用管电流为40 mAs）、30 mAs 组（所用管电流为30 mAs），将其影像学图像质量、辐射剂量进行分析，制定其相应的低剂量扫描方案。结果常规扫描与50 mAs 组优质片率各占70．3％、62．2％，良级片率分别为29．7％、37．8％，两者均未出现差级片；常规扫描与40 mAs 组优质片率各占67．6％、56．8％，良级片率分别为32．4％、43．2％，两者均未出现差级片；常规扫描与30 mAs组：优质片各占70．3％、56．8％，良级片分别为29．7％、43．2％，两者均未出现差级片。图像质量均以优和良为主，在达到诊断要求方面差异无统计学意义（P＞0．05）。常规剂量与低剂量扫描（50 mAs 、40 mAs 、30 mAs），辐射剂量分别为：7．6、2．6、2．1、1．5 mGy ，以30 mAs 组最低，剂量为原来的19．8％。111例患者采用常规扫描与低剂量扫描均达到影像学诊断要求，无1例漏诊、误诊。结论胸部低剂量 CT 扫描在 AIDS 合并 PCP 体质量正常患者影像学表现中完全能满足临床诊治要求，切实可行；同时，为确保图像质量的稳定性，可以采用首次常规剂量扫描，复查中进行低剂量 CT 扫描；胸部低剂量 CT 扫描电压固定为120 kV ，电流采用30 mAs 。
목적：연구저제량 CT 소묘재획득성면역결함종합증（AIDS）합병잡씨폐포자균폐염（PCP）정상체질량111례환자적림상응용，평개기가행성，병건립상응적소묘방안。방법사용미국통용전기（GE）공사 FII 쌍배라선 CT 궤，기관전압치고정위120 kV ，분별채용상규소묘（자동조제 mAs）여저제량소묘，저제량소묘수궤분위50 mAs 조（소용관전류위50 mAs）、40 mAs조（소용관전류위40 mAs）、30 mAs 조（소용관전류위30 mAs），장기영상학도상질량、복사제량진행분석，제정기상응적저제량소묘방안。결과상규소묘여50 mAs 조우질편솔각점70．3％、62．2％，량급편솔분별위29．7％、37．8％，량자균미출현차급편；상규소묘여40 mAs 조우질편솔각점67．6％、56．8％，량급편솔분별위32．4％、43．2％，량자균미출현차급편；상규소묘여30 mAs조：우질편각점70．3％、56．8％，량급편분별위29．7％、43．2％，량자균미출현차급편。도상질량균이우화량위주，재체도진단요구방면차이무통계학의의（P＞0．05）。상규제량여저제량소묘（50 mAs 、40 mAs 、30 mAs），복사제량분별위：7．6、2．6、2．1、1．5 mGy ，이30 mAs 조최저，제량위원래적19．8％。111례환자채용상규소묘여저제량소묘균체도영상학진단요구，무1례루진、오진。결론흉부저제량 CT 소묘재 AIDS 합병 PCP 체질량정상환자영상학표현중완전능만족림상진치요구，절실가행；동시，위학보도상질량적은정성，가이채용수차상규제량소묘，복사중진행저제량 CT 소묘；흉부저제량 CT 소묘전압고정위120 kV ，전류채용30 mAs 。
Objective To evaluate the feasibility and establish the corresponding scanning plan through the clinical application of low-dose CT on diagnostic imaging for 111 AIDS patients with pnenmocystsis carinii pneumonia (PCP)and normal weight .Methods The thesis applied American GE(General Electric Company )FII double-row spiral CT scanner and the kV value is fixed to be 120 kV with the conventional dose (automatic mAs) and low-dose scanning applied respectively during the diagnosis .Meanwhile ,the low-dose scanning was carried out randomly in 50 mAs(50 mAs group) ,40 mAs(40 mAs group) and 30 mAs(30 mAs group) ,and then ,the iconographical imaging quality and radiation dose were analyzed ,the respective low-dose scanning plans was formulated at last .Results The high-quality film ratios for conventional close and 50 mAs group were 70 .3% and 62 .2% respectively ,and the good film ratios were 29 .7% and 37 .8% ,while no poor films occurred in both groups .The high-quality film ratios for conventional close and 40 mAs were 67 .6% and 56 .8% ,the the good film ratios were 32 .4% and 43 .2% and no poor films ,either .The high-quality film ratios for conventional close and 30 mAs were 70 .3% and 56 .8% ,the good were 29 .7% ,43 .2% and no poor films showed between both groups .From the results ,the consequential imaging films mainly show high and good quality ,all films meet the imaging diagnosis requirements and the difference are not statistically significant (P> 0 .05) .The radiation doses of conventional dose and low dose scanning (50 mAs ,40 mAs and 30 mAs groups) were 7 .6 mGy ,2 .6 mGy ,2 .1 mGy and 1 .5 mGy respectively , while the least radiation doses was for 30 mAs group and the corresponding dose is only 19 .8% of the original .The results from 111 patients applied conventional dose (automatic mAs) and low dose scanning all meet the imaging diagnosis requirements without any missed or erroneous diagnosis .Conclusion The chest low-dose CT scanning for AIDS patients with PCP and normal weight can fully meet the clinical diagnosis and treatment ,so it is practical and feasible .Meanwhile ,the conventional-dose scanning can be ap-plied at first and low-dose CT scanning later for reexamination to ensure the stability of image quality .For low-dose chest CT scan-ning ,the voltage fixed is 120 kV and the current 30 mAs .