The study aimed to assess the image quality and diagnostic performance of low-dose Chest Computed Tomography (LDCCT) in detecting pulmonary infections in patients with hematologic malignancies. A total of 164 neutropenic patients underwent 256 consecutive CT examinations, comparing 149 LDCCT and 107 Standard-Dose Chest CT (SDCCT) between May 2015 and June 2019. LDCCT demonstrated a 47% reduction in radiation dose while maintaining acceptable image noise and quality compared to SDCCT. However, LDCCT exhibited lower sensitivity in detecting consolidation (27.5%) and ground glass opacity (64.4%) compared to SDCCT (45.8% and 82.2%, respectively) with all the respectivep-values from unadjusted and adjusted for sex, age, and BMI analyses being lower than 0.006 and the corresponding Odds Ratios of detection ranging from 0.30 to 0.34. Similar trends were observed for nodules ≥3 mm and ground glass halo in nodules but were not affected by sex, age and BMI. No significant differences were found for cavitation in nodules, diffuse interlobular septal thickening, pleural effusion, pericardial effusion, and lymphadenopathy. In conclusion, LDCCT achieved substantial dose reduction with satisfactory image quality but showed limitations in detecting specific radiologic findings associated with pulmonary infections in neutropenic patients compared to SDCCT.
本研究旨在评估低剂量胸部计算机断层扫描（LDCCT）在血液系统恶性肿瘤患者肺部感染检测中的图像质量与诊断效能。2015年5月至2019年6月期间，共对164例中性粒细胞减少症患者进行了256次连续CT检查，其中包含149次LDCCT与107次标准剂量胸部CT（SDCCT）的对比分析。结果显示，与SDCCT相比，LDCCT在保持可接受的图像噪声和质量的同时，辐射剂量降低了47%。然而，在检测实变（27.5%）和磨玻璃影（64.4%）方面，LDCCT的敏感性低于SDCCT（分别为45.8%和82.2%），未经调整及经性别、年龄、BMI校正后的p值均小于0.006，相应的检测比值比范围为0.30至0.34。对于≥3 mm的结节及结节周围磨玻璃晕征也观察到类似趋势，但这些差异不受性别、年龄和BMI影响。而在结节内空洞、弥漫性小叶间隔增厚、胸腔积液、心包积液及淋巴结肿大等征象的检测中，两种方法未见显著差异。综上所述，LDCCT在实现显著剂量降低并保持满意图像质量的同时，与SDCCT相比，在中性粒细胞减少症患者肺部感染相关特定影像学征象的检测方面存在局限性。
肿瘤(癌症)患者之家