CT血管成像对COPD支气管动脉变化与肺功能关系的研究  

The Relationship Between the Changes of Bronchial Artery and the Pulmonary Function in COPD:A Clinical Study Using CT Angiography

作　　者：施珏倩[1] 肖湘生[1] 范丽[1] 管宇[1] 夏艺[1] 于红[1] 

机构地区：[1]第二军医大学附属上海长征医院影像科,上海200003

出　　处：《临床放射学杂志》2015年第5期711-715,共5页Journal of Clinical Radiology

基　　金：国家自然基金资助项目(基金编号:81271572)

摘　　要：目的利用CT血管成像技术(CTA)研究慢性阻塞性肺疾病(COPD)患者支气管动脉的显示及支气管动脉管径与肺功能(PFT)指标间的关系,探索COPD支气管动脉变化与气道重塑的关系。方法回顾性分析43例COPD患者的支气管动脉CTA图像,利用多平面重组(MPR)、最大密度投影(MIP)及容积再现(VR)对患者支气管动脉重建,统计支气管动脉支数,评价支气管动脉的显示情况,测量肺门水平各支支气管动脉管径,并分析支气管动脉管径与肺功能指标(FEV1,FEV1%,FVC,FEV1/FVC)的关系。结果共显示支气管动脉102支。左支气管动脉41支(40.2%),平均管径1.51 mm。右支气管动脉61支(59.8%),平均管径1.98 mm。右支气管动脉管径较左侧粗,具有统计学意义(P=0.001)。右支气管动脉管径与肺功能指标FEV1(r=-0.468,P<0.001)、FEV1%(r=-0.476,P<0.001)、FVC(r=-0.381,P=0.002)、FEV1/FVC(r=-0.468,P<0.001)均呈负相关。左支气管动脉管径与FEV1(r=-0.314,P=0.046)、FEV1%(r=-0.357,P=0.022)呈负相关,与FVC(r=-0.265,P=0.094)及FEV1/FVC(r=-0.284,P=0.072)无显著相关性。结论 CTA可清晰显示COPD患者支气管动脉。右支气管动脉管径较左侧粗。右支气管动脉管径均与肺功能指标呈负相关。左支气管动脉管径与FEV1、FEV1%预呈负相关,说明支气管动脉与COPD的气道结构重塑关系密切。Objective To investigate the correlation between the diameter of bronchial artery and the pulmonary func- tion in patients with chronic obstructed pulmonary disease （COPD） by using CT angiography （CTA）, and to explore the relationship between the changes of bronchial artery and the airway remodeling. Methods The bronchial artery CTA ima- ges of 43 COPD patients were retrospectively analyzed. By using multiplanar reformation （MPR） , maximum intensity pro- jection （MIP） and volume rendering （VR） techniques the bronchial arteries were reconstructed, the number of bronchial arteries was calculated, the visualization of bronchial arteries was evaluated, the diameter of bronchial arteries at pulmonary hilum level was determined, and the relationships between the diameter of bronchial arteries and the pulmonary function in- dexes （FEV1 , FEV1% , FVC and FEVyFVC） were analyzed. Results A total of 102 bronchial arteries were visualized, including left bronchial artery （n =41,40.2% ） and right bronchial artery （n =61,59.8% ）. The mean diameters of the left and right bronchial artery were 1.51 mm and 1.98 mm respectively. The difference in the diameter of bronchial artery between the right and left side was statistically significant （ P = 0. 001 ）. A negative correlation existed between the diameter of the right bronchial artery and pulmonary function indexes, including FEV1 （ r = - 0. 468, P 〈 0.001 ）, FEVI % （ r = - 0.476, P〈0.001）, FVC （r= -0.381, P=0.002） and FEV1/FVC （r= -0.468, P〈0.001） ; a negative correlation also existed between the diameter of the left bronchial artery and FEVI （ r = - 0. 314, P = 0. 046） and FEV1% （ r = - 0. 357, P = 0. 022 ） , while no obvious correlation existed between the diameter of the left bronchial artery and FVC （ r = -0. 265, P = 0. 094） as well as FEVI/FVC （r = -0. 284, P = 0. 072）. Conclusion CTA can clearly display the bronchial arteries in COPD patients. The diameter of the right bronchial artery is significan

关 键 词：慢性阻塞性肺疾病 CT血管成像 支气管动脉 

分 类 号：R563.9[医药卫生—呼吸系统] R816.4[医药卫生—内科学]