定量CT预测肺癌切除术后肺功能的初步研究  

Application of quantitative CT in predicting postoperative pulmonary function in patients with lung cancer

作　　者：刘芳[1] 韩萍[1] 梁惠民[1] 梁波[1] 田志梁[1] 雷子乔[1] 冯敢生[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院放射科,武汉430022

出　　处：《中华放射学杂志》2005年第7期700-704,共5页Chinese Journal of Radiology

基　　金：卫生部科研基金(98-2-093)

摘　　要：目的探讨定量CT(quantitativeCT,QCT)在预测肺癌切除术患者术后肺功能中的应用价值。方法搜集31例手术治疗的肺癌患者,术前均行肺功能检查及呼吸门控定量CT扫描。选择-910^-600HU作为功能性肺实质的密度区间,将CT资料进行定量分析:双肺处于选定区间内的肺实质容积称为全肺功能性肺容积(TFLV),拟行切除的肺(叶、段)内处于选定区间内的肺实质容积称为局部功能性肺容积(RFLV)。术前肺功能测定了用力肺活量(FVC)和第1秒用力呼气量(FEV1·0),根据公式:预测FVC(predictedFVC,pre-FVC)=术前FVC×[1-(RFLV/TFLV)];预测FEV1·0(predictedFEV1·0,pre-FEV1·0)=术前FEV1·0×[1-(RFLV/TFLV)],得到预测的FVC、FEV1·0、FVC%、FEV1·0%,并与术后实际测量的肺功能值之间进行配对t检验及Pearson相关性检验。结果QCT的pre-FVC、pre-FEV1·0、pre-FVC%、pre-FEV1·0%与术后实测值之间具有显著相关性(r分别为0·873、0·809、0·849、0·801,P<0·01),配对t检验两组数据之间均差异无统计学意义。结论定量CT可以准确、简便、有效的预测手术治疗肺癌患者的术后肺功能情况,并且不受患者术前肺功能状况的影响。Objective To assess the usefulness of quantitative CT in predicting postoperative pulmonary function in patients with lung cancer. Methods 31 patients with lung cancer undergoing both pulmonary functional tests and quantitative CT scan before operation were analyzed. A postprocessing CT program was applied to quantitate the volume of lung parenchyma with attenuation of -910 to -600 HU, which was called total functional lung volume. The volume of lung (lobes or segments) with attenuation of -910—-600 HU which would be resected was called regional functional lung volume. FVC and FEV 1.0 were obtained from preoperative pulmonary functional tests. Values of predicted-FVC, predicted-FEV 1.0, predicted-FVC% and predicted-FEV 1.0% were obtained according to the formula: predicted FVC(pre-FVC)=preoperative FVC×[1-(RFLV / TFLV)]; predicted FEV 1.0( pre- FEV 1.0) = preoperative FEV 1.0× [1-(RFLV / TFLV)]. Paired-t test and Pearson correlation test were used to assess the difference and correlation between CT-predicted values and postoperative results of FVC, FEV 1.0, FVC% and FEV 1.0%. Results CT- predicted values correlated well with postoperative FVC, FEV 1.0, FVC% and FEV 1.0% (r were 0.873, 0.809, 0.849 and 0.801 respectively,P<0.01). Conclusion Quantitative CT is an effective and accurate way to predict postoperative pulmonary function in patients undergoing pulmonary resection, regardless of the patients′ preoperative pulmonary functional status.

关 键 词：定量CT 预测 切除术后 步研究 第1秒用力呼气量 FEV1.0 FEV1.0 Pearson 配对t检验 肺癌患者 手术治疗 肺癌切除术 肺功能检查 用力肺活量 肺功能测定 相关性检验 FVC 肺实质 功能性 应用价值 CT扫描 呼吸门控 定量分析 

分 类 号：R734.2[医药卫生—肿瘤]