定量CT评估2型糖尿病肺损害的应用价值  

Application value of quantitative CT in evaluating lung damage in patients with type 2 diabetes mellitus

作　　者：贺程成 方玮玮 屈兆宇 袁若涵 李锦红[1] 黄晓旗 李延静[1] HE Cheng-cheng;QU Zhao-yu;YUAN Nuo-han(Department of Radiology,the Affiliated Hospital of Yanan University,Shanxi 716000,China)

机构地区：[1]延安大学附属医院影像科,陕西716000

出　　处：《放射学实践》2023年第4期441-445,共5页Radiologic Practice

基　　金：陕西省科技厅重点研发计划一般项目(2021SF-254);延安市科技攻关计划项目(2018KS-11);延安市科技惠民计划(2017-HM-07-01)。

摘　　要：目的:通过分析2型糖尿病肺功能损害患者肺部CT定量参数与临床肺功能检测指标的相关性,探讨定量CT评估2型糖尿病肺功能损害的临床应用价值。方法:根据肺功能检查结果,回顾性搜集2型糖尿病(T2DM)伴有肺功能损害的120例患者及60例肺功能正常的健康志愿者(纳入对照组)的胸部CT资料。采用“数字肺”软件行图像后处理,获得肺部各项CT定量参数值,主要包括双肺平均密度、双肺容积、双肺内CT值分别低于-910 HU和-950 HU的区域的容积(LAA910、LAA950)及其占全肺容积的百分比(LAA910%、LAA950%)。采用独立样本t检验或Mann-Whitney U检验对两组肺部CT定量参数进行比较,并采用Pearson或Spearman方法分析T2DM肺部CT定量指标和临床肺功能的相关性。结果:与对照组相比,T2DM组的肺通气功能指标(FVC、FVC%、FEV1、FEV1%)及肺部CT定量指标中的全肺容积、LAA910、LAA950、LAA910%和LAA950%均显著降低(P<0.05),平均密度显著增高(P<0.05)。四项通气功能指标均与全肺容积、LAA910、LAA950、LAA910%和LAA950%均呈正相关(P<0.05),与平均密度呈负相关(P<0.05)。全肺容积诊断T2DM患者伴有肺损害的敏感度为0.883,特异度为0.800,AUC为0.890。结论:定量CT可客观准确地评价T2DM患者肺损伤情况,其中以全肺容积对评估T2DM患者肺功能损害程度的效能最佳。Objective:To explore the application value of quantitative CT in evaluating pulmonary function injury in patients with type 2 diabetes mellitus(T2DM)based on the analysis of the correlation between quantitative parameters of lung CT and the indexes of clinical pulmonary function test.Methods:According to the results of clinical pulmonary function test(CPFT)including FVC,FVC%,FEV1 and FEV1%,the imaging data of 120 T2DM patients with lung injury and 60 healthy controls with normal lung function(HC group)were collected retrospectively.The lung function indexes of quantitative CT(QCT-LFIs)was obtained by image post-processing with"digital lung"software,including mean lung density,the volume of both lungs,low-attenuation area of the lung with attenuation values below-910 Hounsfield units and-950 Hounsfield units(LAA910 and LAA950,respectively),and the ratio of the LAA910 and LAA950 to the whole lung volume(LAA910%and LAA950%).The difference of the lung function indexes of clinical and quantitative CT between the two groups was analyzed by independent sample t-test or Mann-Whitney U-test,and Pearson or Spearman correlation analysis was used to analyze the correlation between them.Results:Compared with the HC group,the CPFT indexes(FVC,FVC%,FEV1 and FEV1%)and the QCT-LFIs including whole lung volume,LAA910,LAA950,LAA910%and LAA950%in the T2DM group were significantly lower(all P<0.05),and the average density was significantly higher(P<0.05).The FVC,FVC%,FEV1 and FEV1%showed positive correlation with the whole lung volume,LAA910,LAA950,LAA910%and LAA950%(all P<0.05),and showed negative correlation with average density(P<0.05).Conclusion:Quantitative CT could objectively and quantitatively evaluate the lung injury in patients with T2DM.Among the QCT indexes,the whole lung volume has better efficacy in diagnose of lung function damage in patients with T2DM.

关 键 词：糖尿病 肺通气功能 肺损害 体层摄影术 X线计算机 定量分析 

分 类 号：R814.42[医药卫生—影像医学与核医学] R563.3[医药卫生—放射医学]