高分辨率CT容积定量技术在慢性阻塞性肺疾病中的应用研究  

The application of quantitative HRCT volumetric technology research in 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,上海200003

出　　处：《医学影像学杂志》2013年第8期1219-1222,共4页Journal of Medical Imaging

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

摘　　要：目的研究HRCT容积量化参数对COPD严重程度的评估,及其与肺功能检查(PFT)指标的相关性。方法61例COPD患者进行HRCT扫描,将HRCT原始数据传至Extended Brilliance Workspace TM后处理工作站,设定吸气末阈值<-950HU为肺气肿区,得出总肺气肿体积(the total emphysema volume,TEV),计算肺气肿指数(emphysema index,EI=TEV/TLV)。COPD各组间比较采用Bonferroni法进行分析,运用Spearman相关分析检验HRCT容积量化参数与PFT指标的相关性。结果不同级别COPD患者HRCT容积量化参数的比较:IV级COPD患者TEV和EI分别与I级或II级间有差异(P<0.005),III级COPD患者EI与I级间有差异(P<0.005),其它各级间TEV和EI均无差异。COPD患者的HRCT容积量化参数TEV和EI与肺功能指标(FEV1、FEV1%、FVC及FEV1/FVC)均有相关性(P<0.005)。当FEV1/预测值的阈值为50%时,TEV和EI与FEV1/FVC分别有中等强度的相关性(P<0.05)。结论 TEV和EI对评价COPD患者疾病的严重程度具有一定的指导意义,且与PFT指标有很好的相关性。[Abstraetl Objective To determine whether the HRCT volumetric parameters can assess the severity of chronic obstruc- tive pulmonary disease and to compare HRCT volumetric parameters with parameters of pulmonary functional testing （PFT） in patients with COPD. Methods 61 consecutive patients with chronic obstructive pulmonary disease （COPD） un- derwent FIRCT. From the volumetric CT data, the total emphysema volume （TEV） was obtained by applying density threshold of 950 HU, the TEV/TLV was calculated as an emphysema index （El）. The different stages of COPD subjects were evaluated using Bonferroni testing. The correlation between the parameters from quantitative CT and PFT was as- sessed using Spearman correlation analysis. Results HRCT volumetric parameters for COPD patients at all stages： The TEV and E1 of Stage IV COPD patients were significantly different from that of Stage I or II （ P d0. 005）. The El showed a signicant difference between Stage III and Stage I （ P 〈0. 005）. TEV and E1 of HRCT volumetric parameters were separately correlated with BMI and pulmonary function tests [forced expiratory volume in the first minute of expira- tion （FEV1）, FEV1 of predicted value （%FEV1）, forced vital capacity （FVC）, and ratio of FEV1 to FVC （FEV1/FVC） （ P 〈0. 005）3. When FEV1 of 50% predicted value was used as threshold, TEV and EI were moderatly correlated with FEV1/FVC （ P 〈0. 05）. Conclusion TEV and EI could reflect the severity of COPD and are separately correlated with parameters of pulmonary functional test.

关 键 词：肺疾病 慢性阻塞性 体层摄影术 X线计算机 肺功能检查 

分 类 号：R561[医药卫生—呼吸系统] R814.42[医药卫生—内科学]