慢性阻塞性肺疾病与正常志愿者的小气道HRCT定量分析的对照研究  

Comparative study on HRCT quantitative analysis of the small airways between chronic obstructive pulmonary disease and normal volunteers

作　　者：于寰[1] 江海林[1] 范丽[1] 管宇[1] 夏艺[1] 肖湘生[1] 

机构地区：[1]第二军医大学附属长征医院影像科,上海200003

出　　处：《实用放射学杂志》2013年第5期726-729,共4页Journal of Practical Radiology

基　　金：国家自然科学基金青年科学基金项目（81000602）;上海市自然科学基金项目（10ZR1438900）.

摘　　要：目的评价不同程度的慢性阻塞性肺疾病（COPD）患者及正常志愿者的高分辨率CT（HRCT）所测量的小气道各径线间的差异。方法选择COPD患者80例，其中COPD1-4级每级各20例，正常志愿者19例。分别行胸部Philips Brilliance 256排iCT扫描及肺功能检查。扫描采集数据重建后，以多平面重建（MPR）方式重建右肺上叶尖段支气管，测盛4-7级支气管壁横截面的气道擘的外径（1））和内径（L），计算出管壁厚度（T）与体表面积（BSA）平方根的比值（T／√BSA）、气道壁面积占气道总截面积百分比（WA％）、支气管管壁厚度与外径比值（TDR）。分析COPD患者气道壁各参数的相关性。结果COPD患者的支气管壁厚度、TDR、WA％均高于正常对照组，且随着病情的加重，管壁增厚，管壁面积的百分比逐渐增大。HRCT所见COPD各组间与对照组的气道参数的改变有统计学差异（P〈0．05）。结论不同级别的COPD患者4-7级支气管均可发乍气道重构，CT表现为不同程度的支气管壁增厚和管腔变窄。Objective To evaluate the differences of diameters of small airway measured by high-resolution CT（ HRCT} between chronic obstructive pulmonary disease（COPD） patients and normal volunteers. Methods 80 patients with COPD,including COPD 1 -4 grade（in 20 cases each grade） and 19 healthy volunteers were emploied in this study. Chest CT scans at Philips Brilliance 256 rows iCT scanner and pulmonary function tests were performed in all eases. The apical segmental bronchi were reconstructed with multi-planar reconstruction（MPR）, the external（D） and inner（L） diameters of bronchi at 4-7 segments were measured at cross-sec tion,the ratio of the square root of the thickness of the bronchial wall（T） and body surface area （BSA） （T/√BSA ） ,airway wall ar- ea of accounting for the total airway cross-sectional area percentage（WA%）, ratio of bronchial wall thickness and diameter （TDR） were calculated. The correlation of airway wall parameters were analysed. Results The bronchial wall thickness,TDR,WA% in the patients with COPD were higher than that in normal control group, and as COPD worsens, which was gradually inceased, and there were significantly statistical differences（P〈0.05）. Conclusion Airway remodeling in COPD patients at the levels of 4-7 segmental bronchus may be oecurred,CT shows varying degress of bronchial wall thickening and luminal narrowing.

关 键 词：肺 慢性阻塞性肺疾病 计算机体层成像 

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