目的 探讨多层螺旋CT低剂量扫 描在鉴别肺部小结节中的应用价值。方 法 选取2015年6月-2017年5月在我院行 胸部CT平扫体检者120例为对象，随机 数字表法将其分为对照组和观察组各60 例，对照组施行胸部多层螺旋CT常规剂 量扫描检查，观察组施行胸部多层螺旋 CT低剂量扫描检查，观察两组肺部结节 检出率和肺部小结节良恶性检出情况， 并比较两种检查方法安全性。结果 对照 组共有50例检出肺部结节，肺部小结节 检出率为84.00%（42/50），而观察组共 有48例检出肺部结节，肺部小结节检出 率为81.25%（39/48），两组肺部小结节 检出率相较无明显差异（P＞0.05）。观 察组肺部小结节良性、不稳定、疑似恶 化检出率分别为9.52%（4/42）、78.57% （33/42）、11.90%（5/42）与对照组的 10.26%（4/39）、76.92%（30/39）、 12.82%（5/39）相较无明显差异（P＞ 0.05）；观察组胸部CT扫描CTDIw、DLP 较对照组明显小，差异有统计学意义（P ＜0.05）；两组影像学图像显示肺部小结 节病灶大小、形态、内部结构等的清晰度 相当。结论 多层螺旋CT低剂量扫描在诊 断鉴别肺部小结节中有明确应用价值，且 安全性高，适于在临床健康体检者中推广 应用。

Objective To investigate the application value of multi-slice spiral CT lowdose scanning in the diagnosis and differential diagnosis of small pulmonary nodules. Methods A total of 120 persons receiving chest CT scan in the hospital from June 2015 to May 2017 were selected as study subjects, and they were divided into the control group and the observation group with 60 cases in each group by the random number table method. The control group was examined by chest multi-slice spiral CTconventionaldose scanning while the observation group was examined by multi-slice spiral CT lowdose scanning. The detection rate of small pulmonary nodules and the detection of benign and malignant small pulmonary nodules in the two groups were observed, and the safety of the two methods was compared. Results There were pulmonary nodules in 50 cases in the control group and the detection rate of small pulmonary noduleswas 84% (42/50). However, there were pulmonary nodules in 48 cases in the observation group and the detection rate of small pulmonary nodules detection rate was 81.25% (39/48)(P>0.05). There was no significant difference in the detection rates of small benignpulmonary nodules, instability and suspected deterioration between the observation group and the control group [9.52% (4/42), 78.57% (33/42), 11.90% (5/42) vs 10.26%(4/39), 76.92% (30/39) and 12.82% (5/39)] (P>0.05). The CTDIw and DLP of chest CT scan in the observation group were significantly smaller than those in the control group(P<0.05). Images of the two groups showed similar clarity of the size, shape and internal structures of small pulmonary nodules. Conclusion Multi-slice spiral CT low-dose scanning is of definite application valuein the diagnosis and differential diagnosis of small pulmonary nodules, with high safety. It is suitable for clinical health examination.