兔百草枯中毒CT肺纹理特征与肾灌注的相关性研究  

Correlation between CT lung texture characteristics and renal perfusion in paraquat poisoning rabbit

作　　者：翟乾 苏云杉 岳梨蓉 毛崇文 尤梦晶 向述天 ZHAI Qian;SU Yunshan;YUE Lirong;MAO Chongwen;YOU Mengjing;XIANG Shutian(Department of Radiology,Fourth Affiliated Hospital of Kunming Medical University,Kunming 650021,China)

机构地区：[1]昆明医科大学第四附属医院(云南省第二人民医院)放射科,昆明650021

出　　处：《国际医学放射学杂志》2020年第4期384-390,共7页International Journal of Medical Radiology

基　　金：云南省应用基础研究(昆医联合专项)资助项目[2017FE468(-226)]。

摘　　要：目的探讨兔百草枯(PQ)中毒致多器官功能损伤的CT肺纹理特征与肾血流量(RBF)的相关性。方法 24只兔随机平均分为PQ组及对照组。PQ组及对照组分别以PQ溶液及等剂量生理盐水灌胃,2组于灌药后2 h、24 h、7 d、14 d行容积CT肺部平扫及肾灌注成像扫描,同时于上述时间点每组随机处死2只兔,解剖取肺、肾组织行常规病理学检查。各时间点提取各组的肺CT纹理特征(形状特征、直方图特征和游程矩阵特征)并测量CT肾灌注参数RBF值,PQ组各时间点RBF值及肺CT纹理特征差异比较采用重复测量方差分析,RBF值与肺CT纹理特征的相关性采用Pearson相关分析。结果肾、肺病理变化:对照组肾皮髓质结构及形态无异常;PQ组灌药后2 h^14 d肾皮质结构出现受损改变并随时间延长呈逐渐加重趋势且不可逆。对照组支气管及肺泡结构未见明显异常;PQ组灌药后2 h^14 d肺组织出现损伤改变并随时间延长呈加重趋势且不可逆。肺部CT影像表现:各时间点对照组兔双肺纹理均清晰,双侧肺野均无明显渗出及实性改变;PQ组灌药后各时间点的肺部CT影像主要表现依次为浅淡磨玻璃影,肺纹理增粗、紊乱,支气管血管束增粗伴支气管扩张、扭曲,实变影并伴空气支气管征,纵隔旁及侧胸壁下气胸形成。PQ组的肺CT纹理特征包括体积、灰度不均匀度、长游程增强及RBF均随时间延长呈逐渐减小趋势,而均值、Perc.50%、短游程增强、行程比均随时间延长呈逐渐增大趋势(P<0.05)。PQ组RBF与肺CT纹理特征体积、灰度不均匀度、长游程增强均呈线性正相关(均P<0.05),而与均值、Perc.1%、Perc.10%、Perc.50%及短游程增强、行程比均呈线性负相关(均P<0.05)。结论 PQ中毒后,兔肺CT纹理特征及RBF可分别量化评估肺、肾损伤,部分肺CT纹理特征和RBF呈线性相关。Objective To investigate the correlation between CT lung texture characteristics and renal blood flow(RBF) in rabbit with multiple organ dysfunction induced by paraquat(PQ) poisoning. Methods Twenty-four rabbits were equally divided into PQ group and control group randomly. The PQ group and the control group were gavaged with PQ solution and equal dose of saline, respectively. Two groups underwent volume CT lung scan and renal perfusion imaging scan at 2 hours, 24 hours, 7 days and 14 days after gavage. Meanwhile, two rabbits were randomly sacrificed in each group, and the lung and renal tissues were dissected for pathological examination.The lung CT texture characteristics(shape features,histogram features and run matrix features) of each group were extracted at each time point and the CT renal RBF values were measured, the differences in RBF value and lung CT texture characteristics between the PQ group at each time point were compared with the analysis of variance on repeated measures, and the correlations between the lung CT texture characteristics and renal RBF were analyzed with Pearson analysis. Results The renal and lung pathological changes: there was no abnormality in the structure and morphology of renal cortex and medulla in the control group;the damage of the renal cortex was gradually worsened from 2 hours to 14 days after administration and irreversible in the PQ group. The bronchi and alveolar structure group presented no significant abnormality in the control group, but was gradually damaged from 2 hours to14 days after administration and showed aggravating trend and irreversible in the PQ group. The lung CT imaging performance: In the control group,the lung texture of the rabbits was clear at each time point, and there was no obvious exudation and solid changes in the bilateral lung fields, but in the PQ group, the CT images of the lungs at each time point after administration showed, in turn, light ground glass shadow, thickened and disordered lung texture, thickened bronchovascular bundle with

关 键 词：百草枯中毒 肺损伤 肾损伤 体层摄影术 X线计算机 纹理分析 灌注功能成像 动物实验 

分 类 号：R563[医药卫生—呼吸系统] R445.3[医药卫生—内科学]