[1]周国华,李建伟,沈海平,等.基于BMI的正位定位像技术在个性化低剂量CT肺结节筛查中应用价值[J].医学信息,2025,38(18):42-46.[doi:10.3969/j.issn.1006-1959.2025.18.009]
　ZHOU Guohua,LI Jianwei,SHEN Haiping,et al.Application Value of BMI-based Anteroposterior Positioning Technologyin Personalized Low-dose CT Screening for Lung Nodule[J].Journal of Medical Information,2025,38(18):42-46.[doi:10.3969/j.issn.1006-1959.2025.18.009]
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基于BMI的正位定位像技术在个性化低剂量CT肺结节筛查中应用价值()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年18期
页码:
42-46
栏目:
论著
出版日期:
2025-09-15

文章信息/Info

Title:
Application Value of BMI-based Anteroposterior Positioning Technologyin Personalized Low-dose CT Screening for Lung Nodule
文章编号:
1006-1959（2025）18-0042-05
作者:
周国华1; 李建伟1; 沈海平1; 邵国华1; 李 浩2; 王 刚1
南方医科大学第十附属医院/东莞市人民医院放射科1，肿瘤内科2，广东 东莞 523000
Author(s):
ZHOU Guohua1;  LI Jianwei1;  SHEN Haiping1;  SHAO Guohua1;  LI Hao2;  WANG Gang1
Department of Radiology1, Department of Oncology2, the Tenth Affiliated Hospital of Southern Medical University/DongguanPeople’s Hospital, Dongguan 523000, Guangdong, China
关键词:
肺结节; 辐射剂量; 低剂量螺旋CT; 体重指数
Keywords:
Lung nodule;  Radiation dose;  Low-dose spiral CT;  body mass index
分类号:
R445
DOI:
10.3969/j.issn.1006-1959.2025.18.009
文献标志码:
A
摘要:
目的 探讨基于BMI的正位定位像技术在个性化低剂量CT肺结节筛查中应用价值。方法 按照随机数字表法将2023年9月-11月我院行肺结节低剂量CT筛查患者分为A组和B组，各112例。A组为常规低剂量组，低剂量CT检查采用管电压110 kV，自动管电流技术，固定参考50 mA，采用常规胸部CT扫描的方式定位（定位方式为肺尖到肺底）；B组为个性化低剂量组，管电压110 kV，自动管电流技术，参考范围40~60 mA，管电流视受检者BMI不同给予相应的扫描剂量，并根据定位方式不同将B组分为B1组（常规胸部CT扫描的方式定位：肺尖到肺底），B2组（基于BMI的正位定位像进行个性化定位：若受检者BMI≥20.85 kg/m2时，扫描范围从T1椎棘突上缘到T12椎棘突下缘；若受检者BMI＜20.85 kg/m2时，扫描范围从T1椎棘突上缘到L1椎棘突下缘）。采取主观和客观两种评价方法分析图像，统计A、B组辐射剂量各指标[容积CT剂量指数（CTDIvol）、剂量长度乘积（DLP）和有效剂量（ED）]，并比较B1、B2组肺底不含肺组织过度扫描薄层1 mm图像层数。结果 B组CTDI、DLP和ED指标低于A组（P＜0.05）；2名高年资医师对图像质量评价的一致性较好（Kappa=0.701），且所有图像质量评分都在3分及其以上，均能满足诊断要求，且A组图像主观评分为（4.42±0.49）分，B组图像主观评分（4.51±0.53）分，组间比较，差异无统计学意义（P＞0.05）。A、B组肺SNR、肺-空气CNR、主动脉SNR、主动脉-竖脊肌CNR比较，差异均无统计学意义（P＞0.05）；B1组肺底不含肺组织过度扫描薄层1 mm图像层数为（29±18）层，多于B2组的（17±12）层，差异有统计学意义（P＜0.05）。结论 基于BMI的正位定位像技术在个性化低剂量CT肺结节筛查中能有效完成肺结节筛查，满足诊断需求，有效降低辐射剂量，减少过度扫描，达到个性化扫描目的且不影响图像质量。
Abstract:
Objective To investigate the application value of BMI-based anteroposterior positioning technology in personalized low-dose CT screening for lung nodules. Methods From September to November 2023, patients who underwent low-dose CT screening for lung nodules in our hospital were randomly divided into two groups for chest low-dose CT examination by using the random number table, with 112 patients in each group. Group A was the conventional low-dose group, using a tube voltage of 110 kV, automatic tube current technology, with a fixed reference of 50 mA, and positioning via conventional chest CT scan (positioning method from the lung apex to the lung base). Group B was the personalized low-dose group, using a tube voltage of 110 kV, automatic tube current technology, with a reference range of 40-60 mA, and the tube current was adjusted based on the BMI of the subjects to provide corresponding scan doses. Group B was further divided into B1 and B2 subgroups based on different positioning methods. Group B1 used conventional chest CT scan positioning (from the lung apex to the lung base), while group B2 used BMI-based anteroposterior positioning for personalized positioning: for subjects with BMI ≥20.85 kg/m2, the scan range was from the upper margin of the T1 vertebral spinous process to the lower margin of the T12 vertebral spinous process; for subjects with BMI <20.85 kg/m2, the scan range was from the upper margin of the T1 vertebral spinous process to the lower margin of the L1 vertebral spinous process. Subjective and objective evaluation methods were used to analyze the images, and various indexes [volumetric CT dose index (CTDIvol), dose-length product (DLP), and effective dose (ED)] of radiation dose in groups A and B were calculated. The number of 1mm thin-slice images without excessive scanning of lung tissue at the lung base was also compared between groups B1 and B2. Results The CTDI, DLP and ED indexes of group B were lower than those of group A (P<0.05). The consistency of image quality evaluation by two senior doctors was good (Kappa=0.701), and all image quality scores were 3 scores or more, which could meet the diagnostic requirements. The subjective score of group A was (4.42±0.49) scores, and that of group B was (4.51±0.53)scores, but there was no significant difference between the two groups (P>0.05). There were no significant differences in lung SNR, lung-air CNR, aortic SNR and aortic-erector spinae CNR between groups A and B (P>0.05). The number of 1 mm image layers without lung tissue in group B1 was (29±18)layers, which was more than (17±12)layers in group B2, and the difference was statistically significant (P<0.05). Conclusion BMI-based anteroposterior positioning technology can effectively complete lung nodule screening in personalized low-dose CT screening, satisfying diagnostic needs, effectively reducing radiation dose, reducing excessive scanning, achieving personalized screening without affecting image quality.

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更新日期/Last Update: 1900-01-01