双源CT支气管容积再现早期诊断一氧化碳中毒大鼠急性肺损伤  

Value of dual-source CT bronchial volume rendering in early diagnosis of acute lung injury in carbon monoxide poisoning rats

作　　者：何家骥[1] 梁小青 徐晓东 张沅[3] 古伟 吴军[3] HE Jiaji;LIANG Xiaoqing;XU Xiaodong;ZHANG Yuan;GU Wei;WU Jun(Department of Neurosurgery,the Second People's Hospital of Lanzhou City,Lanzhou 730046,China;Department of Neurology,the Second People's Hospital of Lanzhou City,Lanzhou 730046,China;Department of Radiology,the Second People's Hospital of Lanzhou City,Lanzhou 730046,China)

机构地区：[1]兰州市第二人民医院神经外科,甘肃兰州730046 [2]兰州市第二人民医院神经内科,甘肃兰州730046 [3]兰州市第二人民医院放射科,甘肃兰州730046

出　　处：《实用放射学杂志》2022年第10期1701-1704,共4页Journal of Practical Radiology

基　　金：兰州市科技计划项目(2017-04-18)。

摘　　要：目的研究双源CT(DSCT)支气管容积再现(VR)对急性一氧化碳中毒(ACOP)大鼠急性肺损伤程度早期诊断价值。方法健康Wistar大鼠静式吸入一氧化碳(CO)(中毒组)1 h建立ACOP模型,对照组20只吸入空气,中毒组按吸入CO浓度分为中度中毒组、重度中毒组,每组20只。中毒后1 h各组大鼠行DSCT胸部扫描得到平扫及重建支气管VR图像。观察2种图像对大鼠急性肺损伤的检出情况。中毒12 h后制作肺组织切片,观察病理学异常,根据影像及病检结果进行统计学分析。结果DSCT胸部平扫对ACOP大鼠急性肺损伤早期的阳性检出率为27.5%(11/40),支气管VR的阳性检出率为70%(28/40),支气管VR的阳性检出率高于DSCT胸部平扫,2种方法检出率的差异有统计学意义(χ^(2)=9.48,P<0.01)。DSCT支气管VR诊断轻、中、重度急性肺损伤准确率分别为66.7%(4/6)、70%(7/10)、83.3%(10/12),DSCT支气管VR分级程度与急性肺损伤病理结果的准确率为75%(21/28),经Kappa检验,Kappa值=0.608,2种结果一致性较好。结论支气管VR对于ACOP大鼠急性肺损伤早期诊断特异性强,可准确判断ACOP大鼠急性肺损伤程度,为CO中毒急性肺损伤诊治提供客观可靠影像学诊断指标。ObjectiveTo probe the early diagnostic value of dual-source computed tomography(DSCT)bronchial volume rendering(VR)on acute lung injury in rats with acute carbon monoxide poisoning(ACOP).Methods Sixty healthy adult Wister rats were randomized into 3 groups,and each group had 20 rats.The rats in the control group inhaled the air,meanwhile other 40 rats statically inhaled CO with different concentrations for 1 h to establish the ACOP models of moderate group and severe group degree.Each rat underwent DSCT for plain chest scan and reconstructed bronchial VR imaging.The detection of acute lung injury in rats by two kinds of imaging were observed.Lung tissue sections were made 12 h after poisoning,and pathological abnormalities were observed.Statistical analysis was performed according to imaging and detection results.Results The positive detection rate of plain chest DSCT in the early stage of acute lung injury in ACOP rats was 27.5%(11/40),less than that of bronchial VR(70%,28/40),with a statistically significant difference(χ^(2)=9.48,P<0.01).The accuracy of DSCT bronchial VR in the diagnosis of mild,moderate and severe acute lung injury was 66.7%(4/6),70%(7/10),and 83.3%(10/12),respectively.The accuracy of DSCT bronchial VR grade and pathological results of acute lung injury was 75%(21/28),with a Kappa value of 0.608,and had good consistency with pathological results.Conclusion Bronchial VR has high diagnostic specificity and accuracy of acute lung injury in ACOP rats,which provides objective and reliable imaging indicators for diagnosis and treatment of CO poisoning acute lung injury.

关 键 词：双源CT 急性一氧化碳中毒 容积再现 急性肺损伤 

分 类 号：R814.42[医药卫生—影像医学与核医学] R749.63[医药卫生—放射医学] R563[医药卫生—临床医学]