3D-DCE MR灌注成像与HRCT容积成像对慢性阻塞性肺疾病肺功能评估的对照研究  

3D-DCE MR Perfusion Imaging Versus HRCT: Pulmonary Functional Loss Assessment of COPD

作　　者：夏艺[1] 管宇[1] 范丽[1] 张铁峰[1] 刘士远[1] 李兵[1] 于红[1] 

机构地区：[1]上海第二军医大学附属长征医院影像科,200003

出　　处：《临床放射学杂志》2013年第5期733-737,共5页Journal of Clinical Radiology

基　　金：国家自然基金青年基金项目(编号:81000602);上海市自然基金项目(编号:10ZR1438900)

摘　　要：目的比较慢性阻塞性肺疾病(COPD)患者MRI灌注值与HRCT容积参数的相关性及其用于评估肺功能的可行性。方法 62例COPD患者分别进行PFT、HRCT及MRI检查。后处理软件自动计算出总肺体积(TLV),设定吸气末阈值<-950 HU为肺气肿区,得出总肺气肿体积(TEV),肺气肿指数(EI)为TEV与TLV的比值。用3D并行采集梯度脉冲序列获得MRI灌注图像原始数据,通过Functool软件得到灌注缺损区信号强度值(SIPD),相对正常肺组织的信号强度(SInormal),并计算得到灌注缺损区与相对正常肺组织的信号强度之比(RSI)。运用Spearman相关分析评价各MRI灌注值与HRCT容积参数的相关性。结果在所有COPD患者中,RSI分别与TLV、TEV和EI有相关性(r=-0.312,P=0.013;r=-0.466,P<0.001;r=-0.476,P<0.001);而SIPD分别与TLV、TEV、EI的相关性稍弱(r=-0.306,P=0.015;r=-0.400,P=0.001;r=-0.394,P=0.002)。在Ⅱ级COPD患者中,RSI分别与TEV和EI有强相关性(r=-0.583,P=0.014;r=-0.623,P=0.008);而SIPD与TLV、TEV和EI有中等强度的相关性(r=-0.495,P=0.043;r=-0.586,P=0.013;r=-0.534,P=0.027)。在Ⅳ级COPD患者中,TLV分别与SIPD、RSI有显著的相关性(r=-0.594,P=0.042;r=-0.713,P=0.009)。而Ⅰ、Ⅲ级COPD患者的MRI灌注与HRCT容积各参数之间无相关性。MRI灌注值与肺功能指标的相关性较HRCT容积量化参数与肺功能指标的相关性强,RSI与FVC(r=0.529,P<0.001)、%FEV1(r=0.655,P<0.001)的相关性好于EI与FVC(r=-0.372,P=0.003)或%FEV1(r=-0.532,P<0.001)的相关性。结论 MRI灌注值与HRCT容积参数间存在明显负的相关性,RSI与EI相比,能更好地评估肺功能。Objective To prospectively compare values of 3D dynamic contrast-enhanced（DCE） MR perfusion imaging with density-based HRCT volumetric parameters in COPD for pulmonary functional loss assessment.Methods 62 patients with COPD underwent PFT,HRCT and 3D-DCE MR perfusion imaging.From the volumetric CT data,the total lung volume（TLV） was calculated automatically and the total emphysema volume（TEV） was obtained by applying density threshold of-950 HU.The TEV/ TLV was calculated as emphysema index（EI）.The 3D MR perfusion data was post processed using Functool,signal intensity of perfusion defects（SIPD）,signal intensity of normal lung perfusion（SInormal） were obtained by selecting region of interest（ROI） and the signal intensity ratio（RSI） of the perfusion defects and normal lung perfusion was calculated.The correlation between the perfusion values of 3D-DCE MRI and the HRCT volumetric parameters was assessed using Spearman correlation analysis.Results The RSI showed good correlation with the TLV,TEV and EI（r=-0.312,P=0.013;r=-0.466,P0.001;r=-0.476,P0.001）for all patients with COPD.In contrast,there was little lower correlation between SIPD and TLV,TEV,EI（r=-0.306,P=0.015;r=-0.400,P=0.001;r=-0.394,P=0.002）.For GOLD Ⅱ patients,the RSI had strong correlation with TEV and EI（r=-0.583,P=0.014;r=-0.623,P=0.008）;the SIPD had moderate correlation with TLV,TEV and EI（r=-0.495,P=0.043;r=-0.586,P=0.013;r=-0.534,P=0.027.The correlation coefficient between the TLV values and the SIPD was r=-0.594（P=0.042）,between the TLV values and the RSI was r=-0.713（P=0.009） for GOLD IV patients.However,there was no correlation between the perfusion values of 3D-DCE MRI and the HRCT volumetric parameters for patients as GOLD Ⅰ and Ⅲ.Correlation between RSI and FVC（r=0.529,P 0.001） and between RSI and %FEV1（r= 0.655,P 0.0001） was better than that between EI and either FVC（r =-0.372,P =0.003） or %FEV1（r =-0.532,P 0.001）.Conclusion There was significant inverse correlation b

关 键 词：慢性阻塞性肺疾病 肺 灌注 磁共振成像 体层摄影术 X线计算机 肺功能检查 

分 类 号：R563.9[医药卫生—呼吸系统]