振动反应成像系统在间质性肺疾病患者肺功能评价中的应用  

A new lung imaging：vibration response imaging applied to evaluate pulmonary function of interstitial lung disease

作　　者：张钰旋[1] 张苑[1] 徐金富[1] 李霞[1] 周瑛[1] 卫平[1] 金晓凤[1] 蒋幸[1] 李惠萍[1] 

机构地区：[1]同济大学附属上海市肺科医院呼吸科,200433

出　　处：《国际呼吸杂志》2012年第10期737-744,共8页International Journal of Respiration

基　　金：基金项目：国家自然基金（30800405,30971323,81170011）;上海市科委重点项目（09411951500）

摘　　要：目的探讨振动反应成像系统（vibrationresponseimaging，VRI）在间质性肺疾病（ILD）患者肺功能评价中的应用价值。方法选取我院2010年6月至2011年9月临床诊断为ILD的患者80例，进行VRIxp肺功能检查，并与传统肺功能进行比较，观察患者肺功能检查前后病情变化，分析VRIxp和传统肺功能在ILD患者肺功能评价上的优劣。结果VRIxp主要参数变化及意义：①观察气流分布图及最大振动能量图发现所有受试者均存在图像不同步、大小不一等不同程度的异常；②69例受检者存在能量分布异常，根据不同疾病类型分组及CT表现分组比较能量值，差异无统计学意义；③能量曲线出现平台及曲线分离等异常表现；④VRIxp可客观定性、定量检出异常呼吸音，且检出率较传统听诊高，分别为90．oo％、82．50％；⑤结合气流分布图及区域能量分布可定位病灶，本组73例VRIxp与CT定位一致，病灶定位准确率达91．25％。与传统肺功能比较：①传统肺功能通气功能正常者VRI检测结果均存在异常，且病变部位与HRCT相符；②肺功能检查前后受检者病情变化评分，传统肺功能检测评分差值为6．59，VRI检测前后评分差值为0．32。VRI对患者病情影响较小。结论VRIxp是一种在患者平静呼吸状态下即可进行肺功能测定的一种新方法，较传统肺功能有诸多优势：可动态、直接、快速且准确地观测到肺容积的变化、判断病变部位和更为敏感地发现肺部异常呼吸音，且对患者病情无影响，特别适用于以呼吸困难为突出表现的ILD患者。Objective To discuss the value of vibration response imagine （VRI） on evaluating the pulmonary function of interstitial lung disease （ILD）. Methods 80 patients who were diagnosed as ILD from June 2010 to September 2011 enrolled in this study. Then, all the patients took the VRIxp pulmonary function test so as to make a comparison with the traditional pulmonary function test. This paper analyzed the advantage and disadvantage of VRIxp and the traditional pulmonary function test in evaluating the pulmonary function of ILD by observing the changes of patients＇ condition after the test respectively. Results The changes and significance of the main VRIxp parameters：（1）By observing airflow distribution map and maximum vibration energy diagram,a variety of abnormities were discovered such as the out-sync of the images and the size difference in all patients. （2）It is found that 69 patients had abnormal energy distribution. According to grouping of the various disease types and CT scan, the energy values were compared which indicated that the abnormities had no statistical significance. （3）The energy curve had some abnormities such as the platform and curve separation. （4）The study showed that VRIxp could qualitatively, quantificationally detect the abnormal breath sounds and VRIxp was more sensitive than that of traditional auscultation （the positive rate were 90.00% vs 82.50%, respectively）. （5）VRIxp could locate the lesion directly by combining air distribution figure with regional energy distribution. The accuracy rate was as high as 91.25% compared with CT scan. Comparing with traditional pulmonary function technology, there were some advantages of VRI. （1）For some patients, their ventilatory functions were detected as normal by traditional pulmonary function technology, while through VRI test, the results were abnormal. And the lesions were consistent with HRCT. （2）By evaluating conditions of patients before and after pulmonary function test, VRIxp was less secondary effe

关 键 词：振动反应成像系统 间质性肺疾病 肺功能 

分 类 号：R563.9[医药卫生—呼吸系统]