目的 探讨高分辨率低剂量CT（HRLDCT）在无症状健康体检者筛查肺部疾病和肺外病变的应用价值。方法 回顾性分析于2011年1月—2021年12月在广州市第一人民医院行胸部HRLDCT检查的1 940例无症状健康体检者的影像学资料,由两位研究者分别评估和记录所有受检者的每一个阳性CT病征征象,分析各个阳性CT征象在总受检人群中的检出情况、各个阳性CT征象在性别、年龄分层中的分布情况,以及肺外阳性CT征象检出情况。比较肺癌和肺良性结节在不同性别、不同年龄段分布中的检出情况。结果 共有1 831例受检者存在阳性CT征象,总检出率为94.38%,共检出3 339个阳性CT征象。检出率最高的阳性CT征象是肺部良性结节（1 630例,84.02%）。在973例男性受检者中,检出肺癌22例（2.26%）,肺良性结节 815例（83.73%）;在967例女性受检者中,检出肺癌19例（1.96%）,肺良性结节815例（84.28%）,肺癌与肺良性结节在不同性别间的检出率比较差异无统计学意义（P=0.64,χ²=0.214）。肺部阳性CT征象的检出率随年龄的增长而升高,肺癌与肺良性结节最多见于51~60岁受检人群中,两者在51~60岁和61~70岁中的检出率比较差异有统计学意义（P=0.038,χ²=4.32）。此外,检出最多的肺外其他阳性CT征象为脂肪肝,共497例（25.62%）,其次是冠状动脉钙化173例（8.90%）。结论 HRLDCT在胸部的健康体检中可同时用于肺部疾病的筛查及发现肺外异常征象,具有较高的临床应用价值。

Objective To investigate the application value of high-resolution low-dose CT（HRLDCT）in screening for lung diseases and extra-pulmonary lesions in asymptomatic healthy individuals．Methods A retrospective analysis was performed on the images of 1 940 asymptomatic healthy individuals who underwent chest HRLDCT examination in our hospital from January 2011 to December 2021．Two investigators conducted independent evaluations and recordings of each positive CT sign in all individuals．An analysis of the detection rates of positive CT signs in the entire population,examining their distribution across various gender and age groups was involved in this study．The detection of positive CT signs outside the lung was also investigated．Additionally,the comparative analysis of lung cancer and benign pulmonary nodules detection across various genders and age cohorts were performed．Results A comprehensive count of 1831 individuals exhibited positive CT signs,resulting in an overall detection rate of 94．38%,with identifying a total of 3339 positive CT signs．The positive CT sign with the highest detection rate was benign pulmonary nodule（1 630 cases,84.02%）．In 973 male participants,22 cases of lung cancer were detected（2.26%）,and 815 cases of benign lung nodules were found（83.73%）．In 967 female participants,19 cases of lung cancer were detected（1.96%）,and 815 cases of benign lung nodules were identified（84.28%）．Statistical analysis revealed no significant difference in the detection rates of lung cancer and benign lung nodules between genders（P=0.64,χ²=0.214）．The prevalence of positive CT signs in the lungs demonstrates an upward trend with advancing age．Notably,individuals aged 51-60 exhibit a higher incidence of lung cancer and benign lung nodules．A statistically significant disparity in the detection rates of these conditions is observed between the 51-60 and 61-70 age cohorts（P=0.038,χ²=4.32）．In addition,the most frequently detected extrapulmonary positive CT findings were fatty liver,with a total of 497 cases（25.62%）,followed by coronary artery calcification with 173 cases（8.90%）．Conclusion sHRLDCT can be effectively employed in the screening of pulmonary conditions and identification of extra-pulmonary abnormalities during thoracic health assessments,demonstrating considerable clinical significance．

目的 探索胸部CT值在胸腔积液鉴别诊断的价值。方法 81例胸腔积液患者纳入本研究,胸腔积液分为渗出液、漏出液、恶性胸腔积液及良性胸腔积液。建立平均CT值的ROC曲线,计算曲线下面积。结果 81例胸腔积液患者中59例为渗出液,22例为漏出液;恶性胸腔积液33例,良性胸腔积液48例。渗出液组平均CT值(16.68±6.76)Hu高于漏出液组(5.50±3.42)Hu(P<0.000 1)。ROC曲线分析结果显示,胸腔积液平均CT值对区分渗出液和漏出液具有较高的准确性(曲线下面积为0.944 5)。当最佳界值为≥9.99 Hu时,其敏感度为88.14%,特异度为90.91%;恶性胸腔积液组平均CT值(15.38±7.29)Hu与良性胸腔积液组平均CT值(12.45±8.03)Hu没有差异(P=0.098 1)。结论 在胸腔积液的鉴别诊断过程中,胸部CT的CT值在鉴别漏出液及渗出液中有一定的价值,但尚不能用于鉴别良性及恶性胸腔积液。

Objective To explore the value of chest CT value in the differential diagnosis of pleural effusion. Methods A total of 81 patients with pleural effusion were included in this study, including exudate, transudate, malignant pleural effusion and benign pleural effusion.The ROC curve of average CT value was established and the area under the curve was calculated. Results Among 81 patients with pleural effusion, 59 cases were exudative, 22 cases were transudative, 33 cases were malignant pleural effusion and 48 cases were benign pleural effusion.The mean CT value of the exudate group, (16.68±6.76) Hu, was significantly higher than (5.50±3.42) Hu of the transudate group (P<0.000 1).ROC curve analysis showed that the mean CT value of pleural effusion had high accuracy in distinguishing exudate from transudate (area under the curve was 0.9445).When the cut-off value for exudative effusion was over 9.99 Hu, the sensitivity and specificity were 88.14% and 90.91%, respectively.The mean CT value of malignant pleural effusion group, (15.38±7.29) Hu, was not significantly different from (12.45±8.03) Hu of benign pleural effusion group (P=0.098 1). Conclusions In the differential diagnosis of pleural effusion, the chest CT value can be used to identify transudate and exudate, but not benign and malignant pleural effusion.

目的 分析毕节地区新型冠状病毒(2019-nCoV)肺炎(novel coronavirus pneumonia,NCP)胸部CT影像学表现,探讨对NCP的临床诊断的价值。方法 回顾性分析毕节市第三人民医院2020年1月14日至2月18日收治的13例NCP患者的流行病学特征及胸部CT影像学特征。结果 13例患者中2例为长期居住在武汉来毕;1例由从上海到湖北宜昌逗留3天返毕;1例直接与武汉当地人接触;3例为与确诊病人的密切接触者;5例是聚集性发病,均与从浙江省台州市返毕确诊病人密切接触;1例无流行病学史。胸部CT影像学以双肺或一侧肺散在斑片状、磨玻璃状高密度影,密度不均,边界不清,肺野外带显著为特征。重型患者短期内肺部CT影像学变化明显。结论 确诊NCP普通型患者胸部CT影像学大多以典型表现为特征;重型NCP患者短时间内可出现实变及肺纤维化。

Objective To analyze the novel coronavirus (2019-nCoV) novel coronavirus pneumonia (NCP) chest CT imaging findings in Bijie area, and to explore the clinical diagnostic value of NCP. Methods The epidemiological characteristics and chest CT features of 13 NCP patients admitted to The Third People's Hospital of Bijie from January 14 to February 18, 2020 were analyzed retrospectively. Results Among the 13 patients, 2 lived in Wuhan for a long time, 1 stayed for 3 days from Shanghai to Yichang, Hubei, and returned home; 1 directly contacted with the local people in Wuhan; 3 closely contacted with the confirmed patients; 5 were clustered diseases, all closely contacted with the confirmed patients returning from Taizhou, Zhejiang province; 1 had no epidemiological history. CT imaging of the chest is characterized by patchy, ground glass high-density shadows scattered in two or one side of the lung, with uneven density, unclear boundary and significant lung field zone. Conclusion Most of the chest CT images of the patients with NCP were characterized by typical manifestations, while consolidation and pulmonary fibrosis were found in the patients with severe NCP in a short period of time.