MSCT肺容积测定在COPD患者肺功能评价中的应用  

Application of measurement of lung volumes from MSCT images in evaluation of pulmonary function of patients with chronic obstructive pulmonary disease

作　　者：李爽[1] 陈亮[1] 杜继民[1] 华树成[2] 

机构地区：[1]吉林大学第一医院放射线科,吉林长春130021 [2]吉林大学第一医院呼吸科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2009年第6期1167-1171,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(200505208)

摘　　要：目的:研究多层螺旋CT(MSCT)肺容积指标与肺功能(PFT)指标的相关性及其在评估慢性阻塞性肺疾病(COPD)方面的应用价值。方法:选择24例COPD患者(COPD组)和22例肺部CT检查正常者(正常组),均在1周内完成肺功能检查及MSCT检查。采用MSCT于最大吸气末和最大呼气末分别扫描全肺,用Pulmo肺定量软件测定全肺容积。应用SPSS13.0软件对CTPulmo软件分析所得结果及PFT检查所得结果进行统计学分析。结果:与正常组比较,COPD组最大吸气末容积(Vin)(P<0.05)、最大呼气末容积(Vex)(P<0.05)、容积比(Vex/Vin)(P<0.01)均明显升高,而容积差(Vin-Vex)(P<0.05)则明显下降。MSCT肺容积指标中,Vin与PFT的肺总量(TLC)(r=0.923,P<0.01)、Vex与残气量(RV)(r=0.912,P<0.05)呈正相关关系,Vin-Vex与肺活量(VC)(r=0.763,P<0.01)、Vex/Vin与残气量和肺总量比(RV/TLC)(r=0.754,P<0.01)也呈正相关关系。Vex与第1秒用力呼气容积实测值与预测值百分比(FEV1%)和第1s用力呼气容积与用力肺活量的比值(FEV1/FVC)有较好的相关性,(r=-0.616,P<0.01;r=-0.543,P<0.05)。与对照组比较,COPD患者Vin、Vex、Vex/Vin均有显著升高(P<0.05,P<0.01),与PFT的表现相一致。结论:MSCT测定的肺容积指标与PFT有很好的相关性,可用于评估COPD患者的肺功能。Objective To explore the application value of lung volumes from 64 multi-slice CT （MSCT） images in patients with chronic obstructive pulmonary disease （COPD） and study the correlation between lung volumes measured by MSCT and pulmonary function test （PFT） results. Methods 24 patients clinically diagnosed with COPD （COPD group） and 22 healthy people （control group） were selected and underwent both chest MSCT scans and PFT within one week. The total lung was scanned at full inspiration and full expiration with MSCT,respectively. The total lung volumes were measured by CT Pulmo software （Siemens,Forchheim,Germany）. The quantitative total lung volumes from MSCT images were compared with PFT and SPSS13.0 was applied to assess the correlation. Results Compared with control group,the full inspiration volume （Vin） （P〈0.05）,the full expiration volume （Vex） （P〈0.05）,and Vex/Vin （P〈0.01）were elevated,while Vin-Vex was declined obviously in COPD group （P〈0.05）.Vin was in positive correlation with total lung capacity （TLC） （r= 0.923 ,P〈0.01） and Vex was also in positive correlation with residual volume （RV）（r= 0.912 ,P〈0.05）,as well as Vin-Vex with vital capacity （VC） （r=0.763,P〈0.01） and Vex/Vin with RV/TLC （r= 0.754 ,P〈0.01）. The Vex showed best correlation with FEV1% and FEV1/FVC （r=-0.616,P〈0.01;r=-0.543,P〈0.05）. Vin,Vex and Vex/Vin were significantly elevated in patients with COPD compared with those in control group. Conclusion Lung volumes obtained from MSCT images show a strong correlation with PFT results in patients with COPD. Lung volumes measured from MSCT images can be used to evaluate the pulmonary function in patients with COPD.

关 键 词：多层螺旋CT 肺容积 慢性阻塞性肺疾病 肺功能 

分 类 号：R563[医药卫生—呼吸系统] R816.41[医药卫生—内科学]