低剂量胸部CT扫描对慢性阻塞性肺疾病相关性肺动脉高压的诊断价值研究  

Diagnostic Value of Low-Dose Chest CT Scan on Chronic Obstructive Pulmonary Disease Related Pulmonar y Arterial Hypertension

作　　者：江丽莎 彭伟清 陈志明[1] JIANG Li-sha;PENG Wei-qing;CHEN Zhi-ming(Department of Medical Imaging,Zhongshan Hospital Affiliated to Guangzhou University of Chinese Medicine,Zhongshan 528400,Guangdong Province,China)

机构地区：[1]广州中医药大学附属中山医院医学影像科,广东中山528400

出　　处：《中国CT和MRI杂志》2022年第3期36-39,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨低剂量胸部CT扫描对慢性阻塞性肺疾病(COPD)相关性肺动脉高压的诊断价值。方法回顾性分析我院2018年7月至2020年1月收治的235例COPD患者临床资料,根据超声心动图测量肺动脉收缩压结果,分为无肺动脉高压组(n=121)、轻度组(n=50)、中度组(n=35)、重度组(n=29),所有患者均通过低剂量胸部CT扫描测量主肺动脉、左肺动脉、右肺动脉直径(MPAD、LPAD、RPAD),计算主肺动脉分别与升主动脉、降主动脉直径的比值(rPA、rPD),分析其在COPD相关性肺动脉高压的诊断价值。结果轻度组患者MPAD、rPA、rPD水平高于无肺动脉高压组,中度组高于轻度组,重度组高于中度组(P<0.05);轻、中、重度肺动脉高压患者RPAD、LPAD水平高于无肺动脉高压组(P<0.05);CT扫描参数联合诊断肺动脉高压ROC曲线下AUC(0.934)高于MPAD、RPAD、LPAD、rPA、rPD单独检测(AUC=0.855、0.593、0.633、0.810、0.804,P<0.05);CT扫描参数联合评估轻中度以及中重度肺动脉高压ROC曲线下(AUC=0.798、0.914)分别高于MPAD、rPA、rPD单独检测(0.722、0.718、0.642、0.774、0.802、0.828,P<0.05);Spermann相关性分析结果显示,MPAD、rPA、rPD水平分别与疾病严重程度呈现正相关(r=0.534、0.502,P<0.05)。结论低剂量胸部CT扫描可有效诊断COPD合并肺动脉高压,MPAD、rPA、rPD联合监测对患者病情评估具有重要价值。Objective To explore the diagnostic value of low-dose chest CT scan in chronic obstructive pulmonary disease(COPD)-related pulmonary arterial hypertension(PAH).Methods A retrospective analysis was performed on the clinical data of 235 patients with COPD in the hospital between July 2018 and January 2020.According to pulmonary artery systolic pressure(PASP)measured by echocardiogram(ECG),they were divided into non-PAH group(n=121),mild group(n=50),moderate group(n=35)and severe group(n=29).The main pulmonary artery diameter(MPAD),left pulmonary artery diameter(LPAD)and right pulmonary artery diameter(RPAD)were measured by low-dose chest CT scan.The ratio of main pulmonary artery diameter to ascending aorta diameter(rPA)and ratio of main pulmonary artery diameter to descending aorta diameter(rPD)were calculated.And their diagnostic value for COPD related PAH was analyzed.Results The levels of MPAD,rPA and rPD were the highest in severe group,followed by moderate group,mild group and non-PAH group(P<0.05).RPAD and LPAD levels in mild,moderate and severe groups were higher than those in non-PAH group(P<0.05).The area under ROC curve(AUC)of all CT scan parameters was higher than that of MPAD,RPAD,LPAD,rPA and rPD alone in the diagnosis of PAH(0.934 vs.0.855,0.593,0.633,0.810,0.804)(P<0.05).AUC values of all CT scan parameters were greater than those of MPAD,rPA and rPD alone for evaluating mild and moderate PAH,as well as moderate and severe PAH(0.798 vs.0.722,0.718,0.642.0.914 vs.0.774,0.802,0.828)(P<0.05).Spermann rank correlation analysis showed that levels of MPAD,rPA and rPD were positively correlated with disease severity(r=0.534,0.502,P<0.05).Conclusion Low-Dose chest CT scan can effectively diagnose COPD combined with PAH.The combined monitoring of MPAD,rPA and rPD is of great value in assessing patients'conditions.

关 键 词：慢性阻塞性肺疾病 肺动脉高压 低剂量胸部CT扫描 诊断价值 

分 类 号：R445.3[医药卫生—影像医学与核医学] R563[医药卫生—诊断学]