不同程度肺气肿MSCT定量测量与视觉评分结果的比较  

Various degrees of emphysema：whole-lung densitometry versus visual assessment measured by MSCT

作　　者：邢志珩[1,2] 万业达[3] 范勇[2] 赵新骞[2] 王恺[2] 程湘[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市海河医院放射科 [3]天津市天和医院放射科

出　　处：《实用放射学杂志》2012年第6期873-876,共4页Journal of Practical Radiology

摘　　要：目的探讨MSCT肺密度定量测量与视觉评分2种方法对不同程度肺气肿的评估价值。方法将30例研究对象分成轻度肺气肿组（A组）与中、重度肺气肿组（B组）。病人行胸部MSCT容积扫描。测量肺气肿指数（EI），计算视觉评分分数（VS），同时记录2种方法所需时间。对A、B2组不同医师间所得到结果的差异性与相关性进行比较。对A、B2组的E1与VS的相关性分别进行比较。对肺密度定量测量和视觉评分所需时间进行比较。结果医师之间肺密度定量测量结果的一致性好于视觉评分结果的一致性（r＝0．99-1．00 vs r=0．35-0．97．P〈0．05）。视觉评分结果医师之间的一致性B组好于A组（r-0．73-0．97 vs r=0．35-0．77，P〈0．05），肺密度定量测量结果的一致性A、B2组之间差异极小（r=0．99-1．00 vs r=0．98-0．99,P〈0．05）。B组病人EI与VS的相关性好于A组病人EI与VS的相关性（r=0．725 vs r=0．317．P〈0．05）。肺密度定量测量平均时间为（7．88±0．80）min．视觉评分平均时间为（4．42±0．40）min。二者之间差异具有统计学意义（P〈0．05）。结论肺密度定量测量与视觉评分结果之间具有相关性。肺气肿定量测量与视觉评分相比医师之间评估结果的一致性更高。肺气肿视觉评分结果的一致性较差，特别是轻度肺气肿时。对轻度肺气肿病人进行评估与随访时应采用定量测量方法。Objective To study the value of visual assessment and multi-slice spiral computed tomography （MSCT） measurement of pulmonary emphysema in different degrees. Methods According to the results of pulmonary function test, 30 subjects were di vided into two groups： the mild emphysema group（group A） and the moderate and severe emphysema group（group B）. MSCT stud ies in all patients were performed . The emphysema index（EI） and visual seore（VS） were measured, and the time required for as- sessment were recorded. The difference and correlation between the results of inter-observers, group A and group B were compared. The correlation of EI and VS between group A and B was compared, and the average times for the lung densitometry measurement and VS were also compared. Results The inter-operator agreement of lung densitometry measured by CT was better than visual score（r=0.99-1.00 vs r=0. 35-0. 97, P〈0.05）. The inter-operator agreement of visual score in group B was better than group A（r=0.73-0.97 vs r= 0.35-0.77, P〈0.05）. The differences in agreement of densitometry between group A and group B were mild（r=0. 99- 1. 0（3 vs r=0. 98-0.99, P〈0. 05）. Tbe correlation of El and VS in group B was better than that in group A（r=0.725 vs r=0.317, P〈0. 05 ）. The difference between the time for densitometry measurement （7.88 min±0.80 min） and VS （4.42 min±0.40 min） was statistically significant（P〈0.05）. Conclusion There is a correlation between the results of lung densi tometry and VS in pulmonary emphysema measured by MSCT. Lung densitometry enable a better inter-operator agreement of the results than visual score in evaluating the extent of emphysema. Lower agreement is observed between operators of visual score, es peeially in the mild emphysema group. We should adopt the method of lung densitometry for the measurement and follow-up of mild emphysema.

关 键 词：肺 肺气肿 体层摄影术 X线计算机 肺密度 视觉 

分 类 号：R563.3[医药卫生—呼吸系统] R814.42[医药卫生—内科学]