定量CT对肺泡蛋白沉着症肺泡灌洗术前后的应用分析  

Quantitative CT Analysis Before and After Bronchoalveolar Lavage in Patients with Pulmonary Alveolar Proteinosis

作　　者：刘勇彬[1] 曾庆思[2] 马壮[1] 刘琴[2] 陈淮[2] 杨兴桂[1] 曾焕忠[1] 

机构地区：[1]广东医学院附属厚街医院放射科,东莞523945 [2]广州医学院第一附属医院放射科,510120

出　　处：《临床放射学杂志》2014年第3期365-368,共4页Journal of Clinical Radiology

基　　金：广州医学院基金研究课题(编号:A2011013)

摘　　要：目的探讨并评估定量CT在肺泡蛋白沉着症(PAP)支气管肺泡灌洗术中的应用价值。方法通过定量CT分析PAP患者最大吸气末肺气体总容积、肺总重量、肺平均CT值、肺平均密度值结果及像素指数直方图,对15例PAP患者共18次行肺泡灌洗术的CT资料进行定量分析,并结合肺功能检查(共14次)资料进行对比。结果 PAP经支气管肺泡灌洗术后,定量CT检查显示肺气体总容积有一定程度的增加(P=0.128),肺总重量从(1698±409)g减至(1307±381)g(P=0.001),平均CT值从(-761.7±36.1)HU减至(-895.7±26.3)HU(P=0.015),肺平均密度值从(0.5867±0.15)g/cm3减低至(0.4453±0.07)g/cm3(P=0.007)。像素指数直方图直观显示灌洗后像素指数范围较灌洗前减小。支气管灌洗术后有14次肺功能检查结果显示DLCO%从(50.15±19.18)%上升至(56.37±17.89)%(P=0.018)、DLCO/VA%从(70.01±19.18)%上升至(78.17±15.36)%(P=0.045);用力肺活量(FVC)、第一秒用力呼气量占预计值的百分比(FEV1%)、FEV1/FVC亦有不同程度的改善,但均无统计学意义(P>0.05)。结论定量CT可对PAP灌洗术的疗效评估提供比较客观、精确的依据,为临床评估PAP肺泡灌洗术的疗效提供新的评价方法。Objective To evaluate the application value of the quantitative CT in pulmonary alveolar proteinosis （PAP） of bronchoalveolar lavage. Methods Quantitative CT was used to analyze PAP patients＇results including maximal end tidal total lung volume, total lung weight, lung mean CT, mean lung density, the CT data in 15 cases of PAP with a total of 18 times the bronchoalveolar lavage combined with pulmonary function test （ a total of 14 times） were analyzed. Results PAP after hronchoalveolar lavage, quantitative CT showed that there was a certain degree increased in the maximal end tidal total lung volume （P =0. 128）, total lung weight decreased from （1698 ＋ 409） to （1307 ＋ 381 ） g （P =0. 001 ）, lung mean CT value decreased from （761.7 ~ 36.1 ） HU to （ 895.7 ± 26.3 ） HU （ P = O. 015 ）, the mean lung density from （0. 5867 ± 0.15 ） reduced to （0, 4453 ± 0.07 ） g/cm3 （ P = 0. 007 ）. The pixel index reduced after bronchoalveolar lavage. After bronchial lavage, there were 14 times about the results of pulmonary function tests showed DLCO% from （50.15 ± 19.18）% up to （56.37 ± 17.89）% （P = 0. 018）, DLCO/VA% increased from （70.01 ± 19.18）% to （78. 17 ± 15.36）% （P =0.045） ; FVC, FEVI% , FEV1/FVC also improved in some extent, but there were no obvious statistical significance （P 〉 0.05）. Conclusion Quantitative CT can provide more objective, accurate basis to evaluate the effects of PAP lavage, and also provide a new reference for the clinical assessment of PAP bronchoalveolar lavage.

关 键 词：肺泡蛋白沉着症 支气管肺泡灌洗术 体层摄影术 X线计算机 定量 

分 类 号：R563.9[医药卫生—呼吸系统]