双气相CT支气管参数对慢性阻塞性肺疾病通气受限诊断的价值  

Correlation between bronchial dimensions and airflow limitation in patients with COPD by biphasic quantitative CT

作　　者：高小燕 曹宪宪 梁志冉 李辉安 金晨望[1] 郭佑民[1] GAO Xiaoyan;CAO Xianxian;LIANG Zhiran;LI Hui'an;JIN Chenwang;GUO Youmin(Department of Radiology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Radiology,Ankang People's Hospital,Ankang,Shaanxi Province 725000,China;Department of Radiology,Tianjin Medical University Cancer Hospital,Tianjin 300000,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]天津医科大学肿瘤医院放射科,天津300000 [3]安康市人民医院影像科,陕西安康725000

出　　处：《实用放射学杂志》2020年第9期1484-1488,共5页Journal of Practical Radiology

摘　　要：目的探讨计算机辅助评估慢性阻塞性肺疾病(COPD)患者吸、呼双气相CT支气管参数与通气受限的相关性.方法回顾性收集"数字肺"数据库中行吸、呼双气相CT扫描和肺功能检查(PFT)的COPD患者89例,并定量测量COPD患者双肺第3~9代支气管壁厚(WT)、管壁面积百分比(WA%)值.采用吸气相与呼气相差值表示双气相支气管参数的变化.分析支气管参数在单独吸、呼气相及双气相下与肺功能的相关性.结果两肺第3~8代支气管WT吸气相与呼气相差异有统计学意义(P<0.05).双气相下WT差值与肺功能相关的代数较吸气相明显增多;在呼气相下WT与肺功能不相关.吸气相与呼气相WA%值无差异,且基本与肺功能不相关.结论在吸气相下的WT及双气相下WT差值与肺功能的相关性较呼气相好,其中呼吸运动中WT的动态变化较静态可更好地评估COPD患者气流受限,双气相下右肺WT差值可能是较好地评估COPD气流受限的CT指标.Objective To investigate the relationship between the biphasic bronchial quantitative CT parameters and ventilation restriction in chronic obstructive pulmonary disease(COPD)patients using computer aided assessment.Methods 89 COPD patients who underwent inspiratory CT scan,expiratory CT scan and pulmonary function test(PFT)were retrospectively recruited from the“Digital Lung”database.The wall thickness(WT)and wall area ratio(WA%)of the third to the ninth generations of the bronchi were quantitatively measured.The differences of the bronchial parameters between inspiratory and expiratory phase were used to indicate the significant change of the parameters between two phases.The relationship among the biphasic difference of the bronchial parameters,the bronchial parameters of the inspiratory phase,the parameters of the expiratory phase and the pulmonary function were analyzed.Results There were significant differences between the WT of the inspiratory phase and the expiratory phase from the 3rd to the 8th generations(P<0.05).For the relationship between the WT and pulmonary function,the number of the algebras of the biphasic difference of WT that correlated with the pulmonary function was significantly greater than that of the inspiratory phase.There was no correlation between expiratory WT and pulmonary function.There was no significant difference in WA% between the inspiratory phase and the expiratory phase,and there was no correlation between WA%and pulmonary function.Conclusion The correlation among the biphas ic difference of WT,the WT of the inspiration and the pulmonary function are greater than that of the expiration.The dynamic change of WT in respiratory movement is better than static state for the evaluation of airflow restriction in COPD patients.The biphasic WT differences of the right lung may be a better CT index for the evaluation of airflow limitation in patients with COPD.

关 键 词：慢性阻塞性肺疾病 支气管壁厚 支气管管壁面积百分比 计算计体层成像 肺功能检查 

分 类 号：R563[医药卫生—呼吸系统] R814.42[医药卫生—内科学]