定量CT评价急性发作期哮喘患者气道重塑、肺气肿及空气潴留情况  

Quantitative CT to Evaluate Airway Remodeling,Emphysema and Air Trapping in Patients with Exacerbated Asthma

作　　者：夏亭亭[1] 郑吴熙 张筱娴[2] 黄晓燕[1] 关玉宝[4] XIA Tingting;ZHENG Wuxi;ZHANG Xiaoxian(Department of Radiology,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong Province 510000,P.R.China)

机构地区：[1]广州医科大学附属第一医院放射科,510000 [2]广州医科大学附属第一医院呼吸内科,510000 [3]广州中医药大学第二附属医院放射科,510000 [4]广州医科大学附属第五医院放射科,510000

出　　处：《临床放射学杂志》2023年第2期269-274,共6页Journal of Clinical Radiology

基　　金：广东省医学科学技术研究基金项目(编号:A2021146)。

摘　　要：目的采用低剂量CT扫描及定量分析技术评价急性发作期哮喘患者气道重塑、肺气肿及空气潴留情况。方法2017年3月至2018年8月搜集40例(非重症17例,重症23例)急性发作期哮喘患者及33名健康对照者,均行低剂量呼吸双相CT扫描,利用后处理软件获得定量CT指标包括:气腔面积与体表面积之比(LA/BSA)、管壁面积与体表面积之比(WA/BSA)、气管厚度与体表面积之比(T/BSA)、管壁面积百分比(WA%)及假定气管内周径为10 mm时管壁面积的平方根(Pi10),肺气肿指标为吸气相体素指数小于-950 HU肺容积占总肺容积百分比[吸气相VI_(-950)(%)],空气潴留指标包括呼气相平均肺密度(呼气相MLD)和呼气相体素指数小于-856 HU肺容积占总肺容积百分比[呼气相VI_(-856)(%)]。采用单因素方差分析或秩和检验(Kruskal-Wallis H)对上述指标进行统计学分析。结果气道重塑指标:非重症哮喘、重症哮喘及健康对照组LA/BSA分别为(9.32±3.84)mm^(2)/m^(2)、(10.09±4.13)mm^(2)/m^(2)、(12.93±5.02)mm^(2)/m^(2),三组差异有统计学意义(F=4.71,P值=0.012);T/BSA分别为(0.98±0.10)mm/m^(2)、(1.06±0.19)mm/m^(2)、(0.92±0.13)mm/m^(2),三组差异有统计学意义(F=5.47,P值=0.006);WA%分别为(67.65±3.86)%、(67.67±5.23)%、(61.71±4.42)%,三组差异有统计学意义(F=15.17,P值<0.001);Pi10分别为(4.46±0.36)mm、(4.62±0.51)mm、(4.01±0.28)mm,三组差异有统计学意义(F=16.63,P值<0.001)。肺气肿指标:非重症哮喘、重症哮喘及健康对照组吸气相VI_(-950)(%)分别为2.01(3.20)%、4.23(20.51)%、0.41(0.66)%,三组差异有统计学意义(H=27.12,P值<0.001)。空气潴留指标:非重症哮喘、重症哮喘及健康对照组呼气相MLD分别为-(762.30±32.05)HU、-(735.06±71.87)HU、-(671.28±44.83)HU,三组差异有统计学意义(F=18.01,P值<0.001);呼气相VI_(-856)(%)分别为19.37(16.04)%、18.60(28.19)%、1.59(4.60)%,三组差异有统计学意义(H=27.91,P值<0.001)。结论急性发作期非重症�Objective To explore airway remodeling,emphysema and air trapping in exacerbated asthmatic patients with quantitative CT analysis technique.Methods 40 exacerbated asthmatic patients(17 non-severe asthmatics,23 severe asthmatics)and 33 healthy control subjects were collected from March 2017 to August 2018.All subjects underwent low-dose respiratory dual phase CT scanning.Using quantitative CT postprocessing software to obtain airway indices,included the ratio of lumen area to body surface area(LA/BSA),the ratio of wall area to body surface area(WA/BSA),the ratio of thickness to body surface area(T/BSA),percent of wall area(WA%)and the wall area for a hypothetical airway with a internal airway perimeter of 10 mm(Pi10)as airway remolding indexes,percent voxels index less than-950 HU[VI_(-950)(%)]of inspiratory as emphysema index,mean lung density(MLD)and percent voxels index less than-856 HU[VI_(-856)(%)]of expiratory as air trapping indexes.Using One-Way ANOVA or H Kruskal-Wallisto analyze the above indicators.Results Airway remodeling indexes,LA/BSA of each group was(9.32±3.84)mm^(2)/m^(2),(10.09±4.13)mm^(2)/m^(2)and(12.93±5.02)mm^(2)/m^(2)for non-severe asthmatics,severe asthmatics and healthy control group respectively,and there was significant difference between the three groups(F=4.71,P=0.012).T/BSA of each group was(0.98±0.10)mm/m^(2)、(1.06±0.19)mm/m^(2)and(0.92±0.13)mm/m^(2)for non-severe asthmatics,severe asthmatics and healthy control group respectively,and there was significant difference between the three groups(F=5.47,P=0.006).WA%of each group was(67.65±3.86)%,(67.67±5.23)%and(61.71±4.42)%for non-severe asthmatics,severe asthmatics and healthy control group respectively,and there was significant difference between the three groups(F=15.17,P<0.001).Pi10 of each group was(4.46±0.36)mm,(4.62±0.51)mm and(4.01±0.28)mm for non-severe asthmatics,severe asthmatics and healthy control group respectively,and there was significant difference between the three groups(F=16.63,P<0.001).Emphysema index,V

关 键 词：哮喘 急性发作 气道重塑 空气潴留 体层摄影术 X线计算机 

分 类 号：R562.25[医药卫生—呼吸系统] R816.4[医药卫生—内科学]