慢性阻塞性肺疾病患者CT表型分类与肺功能检查的相关性分析  

Correlation between CT features and pulmonary function test in different CT phenotypes of chronic obstructive pulmonary disease

作　　者：黄小波[1] 王述红[2] 郑霞[3] 张剑[1] 华正锋 

机构地区：[1]成都军区昆明总医院放射科,云南昆明650032 [2]成都军区昆明总医院呼吸内科,云南昆明650032 [3]昆明市中医医院放射科,云南昆明650051

出　　处：《中国医学影像技术》2014年第12期1861-1864,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨不同慢性阻塞性肺疾病(COPD)CT表型CT特征与肺功能检查(PFT)指标的相关性。方法回顾性分析72例COPD患者CT和临床资料,其按CT特点将其分为A型、E型和M型,CT图像中检测肺气肿区域体素容积占全肺容积的百分比,即像素指数(PI-950),比较不同分型COPD患者PI-950差异,并分析PI-950与PFT指标,包括1秒钟用力呼气容积(FEV1)实测值占预计值百分比、FEV1/用力肺活量(FVC)和残气量(RV)/肺总量(TLC)的相关性。结果A型32例、E型19例、M型21例,其PI-950分别为5.17%(1.63%,7.97%)、26.70%(19.79%,44.13%)和23.20%(15.24%,32.49%),A型低于其他两型(P均<0.05)。A型和E型患者PI-950均与FEV1实测值占预计值百分比和FEV1/FVC呈负相关、与RV/TLC正相关(P均<0.05),M型患者PI-950与FEV1实测值占预计值百分比、FEV1/FVC、RV/TLC均无相关性(P均>0.05)。结论通过CT特征对COPD进行分类可为COPD患者的个性化治疗提供一定的帮助。Objective To explore the correlation CT features and pulmonary function test（PFT）in different CT phenotypes of chronic obstructive pulmonary disease（COPD）.Methods CT and clinical data of 72 patients with COPD were retrospectively analyzed.The patients were classified into A,E and M phenotype according to the findings of CT.The percentage of emphysema lesion voxel volume for the total lung volume that was pixel index（PI-950）was measured and compared among different COPD phenotypes,the correlation between PI-950 and PFT indexes including percentage of measured value for predicted value of forced expiratory volume at 1second（FEV1）,FEV1/forced vital capacity（FVC）and residual volume（RV）/total lung capacity（TLC）were analyzed in each of three phenotypes.Results There were 32 of A,19 of E and 21 of M phenotype.PI-950 in A phenotype 5.17%（1.63%,7.97%）was statistical lower than that in E phenotype26.70%（19.79%,44.13%）and M phenotype 23.20%（15.24%,32.49%,both P〈0.05）.In the A and E phenotype,PI-950 were negatively correlated with percentage of measured value for predicted value of FEV1 and FEV1/FVC,and positively correlated with RV/TLC（all P〈0.05）.There were no correlations between PI-950 and percentage of measured value for predicted value of FEV1,FEV1/FVC,RV/TLC in M phenotype（all P〉0.05）.Conclusion The phenotypes according to the findings of CT is helpful for the individualized treatment of COPD.

关 键 词：肺疾病 慢性阻塞性 肺功能检查 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R563[医药卫生—放射医学]