多层螺旋CT评价肺气肿患者肺功能的可行性  

Multi-sfice CT pulmonary function evaluation in emphysema

作　　者：葛虓俊[1] 张国桢[1] 朱砚萍[2] 单琳[2] 毛定飚[1] 丁其勇[1] 滑炎卿[1] 

机构地区：[1]上海华东医院放射科,200040 [2]上海华东医院肺功能室,200040

出　　处：《中华放射学杂志》2007年第3期243-247,共5页Chinese Journal of Radiology

基　　金：上海市科技发展基金(004119011)

摘　　要：目的探索建立肺气肿通气功能障碍的CT分级标准及可行性。方法147例受试者自愿接受多层螺旋CT（MSCT）及常规肺功能（PFT）检查，间隔不超过1周。以数字表法将患者随机分成2组：A组120例，比较MSCT肺功能与PFT之间的相关性，并以PFT为金标准将其分为正常、轻、中、重度肺功能损害4组，用来建立肺气肿通气功能障碍的MSCT分级标准。B组27例，评估上述分级标准的准确性。测定CT肺功能的定量指标：容积比（Vex／in）、吸气相平均肺密度（MLDin）、呼气相平均肺密度（MLDex）、平均肺密度比（MLDex／in）、吸气相-910HU的像素指数（Piin-910）、呼气相-910HU的像素指数（Piex-910）、-910HU的像素指数比（Piex／in-910）。结果MSCT肺定量指标与PFT之间存在相关性，其中以Piex／in-910与FEV1％的相关性最佳（r=-0．905，P＜0．01）。正常肺功能者60例，轻度下降者22例，中度下降者21，重度下降者17例，所建立的分级标准能较好地反映肺气肿通气功能障碍，其中以Piex／in-910诊断效能最高（x^2=0．267，P=0．966，准确性81．5％），其初步标准为：正常0～9．9，轻度10．0～34．9，中度35．0～74．9，重度≥75．0。结论MSCT肺定量指标评价肺气肿通气功能障碍是可行的，其中以Piex／in-910诊断效能最高。Objective To explore the feasibility of evaluating the lung function by MSCT in emphysema. Methods The MSCT scan and pulmonary function tests （PFT） were respectively performed in 147 receptors within one week. They were randomly divided into 2 groups： group A （120 receptors）, including normal, mild, moderate and severe abnormal pulmonary function based on the PFT, for comparing the correlation between pulmonary quantitative indexes of MSCT pulmonary function and PFT and settingup the primary grade criteria of abnormal pulmonary function in emphysema, group B （27 receptors ） for evaluating the diagnostic accuracy in group A, The total lung was respectively scanned at the full inspiration and full expiration with MSCT. The pulmonary quantitative indexes of MSCT were measured with Siemens Pulmo pulmonary quantitative software. Results There was correlation between pulmonary quantitative indexes of MSCT and PFT. The Piex/in-910 showed best correlation with FEV1 % （r = -0. 905 ,P 〈 0. 01 ）. Compared with PFT, the abnormal pulmonary function of emphysema was well evaluated by the MSCT grade criteria, including normal in 60 cases, mild abnormality in 22 cases, moderate abnormality in 21 cases and severe abnormality in 17 cases.. The most effective quantitative index of MSCT was Piex/in-910 （ X^2 = 0.267,P = 0, 966, accuracy 81.5% ）, and the primary criteria for abnormal pulmonary function of emphysema was normal （0-9. 9）, mild （ 10.0-34. 9）, moderate （35.0-74. 9） and severe （975.0）. Conclusion It is feasible to evaluate the abnormal lung function of emphysema with pulmonary quantitative indexes of CT. The Piex/in-910 was the most effective one in various indexes.

关 键 词：体层摄影术 X线计算机 呼吸功能试验 肺疾病 肺气肿 

分 类 号：R563.3[医药卫生—呼吸系统] R816.4[医药卫生—内科学]