Department of Internal Medicine, Pusan National University School of Medicine, Busan 43241, Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan 43241, Korea.
Medicina (Kaunas). 2020 Sep 19;56(9):479. doi: 10.3390/medicina56090479.
: Thin-section computed tomography (CT) is essential for identifying small bronchi during bronchoscopy using radial endobronchial ultrasound. Some patients should receive an additional CT for a thin-section image. We performed a retrospective study with a prospectively collected database to identify the optimal radiation dose for thin-section CT during peripheral bronchoscopy. : In total, 91 patients with peripheral lung lesions underwent thin-section CT (both standard CT as a reference and ultra-low-dose CT (ultra-LDCT)). The patients were randomly assigned to one of four groups according to the ultra-LDCT parameters: group 1 = 120 kVp, 25 mAs; group 2 = 100 kVp, 15 mAs; group 3 = 120 kVp, 5 mAs; and group 4 = 100 kVp, 5 mAs. Two radiologists and two physicians analyzed both the standard CT and ultra-LDCT. : The effective doses (EDs) of ultra-LDCT significantly differed among the four groups (median EDs were 0.88, 0.34, 0.19, and 0.12 mSv for groups 1-4, respectively; < 0.001). Median differences in peripheral airway wall thickness were higher in group 4 than in other groups (differences in median wall thickness measured by two radiologists were 0.4-0.5 mm and 0.8-0.9 mm for groups 1-3 and group 4, respectively). Bronchus signs on ultra-LDCT in groups 1 and 2 were well correlated with those of the standard-dose CT (accuracies of two radiologists and two pulmonary physicians were 95-100%). : Our results indicate that ultra-LDCT with ED of >0.34 mSv (ED of group 2) is feasible for peripheral bronchoscopy.
经径向支气管内超声引导的支气管镜检查中，进行小支气管识别时，薄层 CT 检查必不可少。部分患者需接受额外的薄层 CT 检查以获取薄层图像。本研究通过前瞻性收集数据库进行了一项回顾性研究，旨在确定外周支气管镜检查中进行薄层 CT 检查的最佳辐射剂量。
共 91 例外周肺病变患者接受了薄层 CT（标准 CT 作为参考和超低剂量 CT（ultra-LDCT））检查。患者根据 ultra-LDCT 参数随机分为四组：组 1 = 120 kVp，25 mAs；组 2 = 100 kVp，15 mAs；组 3 = 120 kVp，5 mAs；组 4 = 100 kVp，5 mAs。两名放射科医生和两名医生分析了标准 CT 和 ultra-LDCT。
四组的超低剂量 CT 有效剂量（ED）差异有统计学意义（组 1-4 的 ED 中位数分别为 0.88、0.34、0.19 和 0.12 mSv；<0.001）。组 4 的外周气道壁厚度的中位数差异大于其他组（两名放射科医生测量的中位壁厚度差异分别为 0.4-0.5mm 和 0.8-0.9mm，组 1-3 和组 4）。组 1 和 2 的 ultra-LDCT 支气管征象与标准剂量 CT 高度相关（两名放射科医生和两名肺病医生的准确率为 95-100%）。
我们的研究结果表明，对于外周支气管镜检查，ED 大于 0.34 mSv（组 2 的 ED）的超低剂量 CT 是可行的。
