老年体检人群肺气肿严重程度及小气道病变的低剂量CT定量评估  

Quantitative assessment of different severity emphysema and small airway lesions in the elderly doing physical examination based on low-dose CT

作　　者：任鑫月 赵月琳 周莹 REN Xinyue;ZHAO Yuelin;ZHOU Ying(Kangda College of Nanjing Medical University,Lianyungang,Jiangsu Province 222061,China;Department of Imaging,the First Affiliated Hospital of Kangda College,Nanjing Medical University,Lianyungang,Jiangsu Province 222061,China)

机构地区：[1]南京医科大学康达学院,江苏连云港222061 [2]南京医科大学康达学院第一附属医院影像科,江苏连云港222061

出　　处：《实用放射学杂志》2023年第9期1522-1525,共4页Journal of Practical Radiology

基　　金：连云港市卫生计生科技面上项目(202007)。

摘　　要：目的 探讨低剂量CT(LDCT)对老年体检人群不同程度肺气肿和小气道病变的定量评估价值.方法 收集 91 例老年体检者的胸部 LDCT影像数据及肺功能数据.采用滤波反投影(FBP)卷积核 B41s和基于图像域迭代(IRIS)重建算法卷积核 I41s、I80 s对图像进行重建,分析不同重建算法对肺气肿严重程度的诊断效能及小气道参数与肺气肿严重程度的相关性.结果 不同重建算法图像质量差异有统计学意义(P<0.001),I41s 组的图像质量最佳,噪声最低,噪声比及对比噪声比(CNR)最高.I41s 对轻度肺气肿的准确性、敏感性最高;I80s对中度肺气肿的准确性、特异性最高;B41s 与 I41s 对重度肺气肿的准确性一致.轻至重度、中至重度肺气肿支气管管壁厚度组间差异有统计学意义(P=0.01,P=0.04).不同程度肺气肿管腔面积百分比(Ai%)及管壁面积百分比(WA%)组间差异有统计学意义(P=0.002),且肺气肿严重程度与 Ai%呈负相关(r=-0.51),与 WA%呈正相关(r= 0.5).结论 胸部 LDCT对老年体检人群肺气肿早期筛查具有可行性,且 IRIS算法对肺气肿严重程度和小气道病变定量评估的准确性优于 FBP.Objective To explore the value of quantitative assessment of different degree emphysema and small airway lesions in the elderly doing physical examination by low-dose computed tomography(LDCT).Methods The data of chest LDCT and lung function of the elderly(n=91)were retrospectively collected.The images were reconstructed by using filtered back-projection(FBP)convolution kernel B4ls and iterative reconstruction in image space(IRIS)reconstruction algorithm convolution kernel I4ls and I8Os.The diagnostic efficacy of different reconstruction algorithms for emphysema severity,as well as the correlation between emphysema and small airway lesions were further analyzed,respectively.Results There was statistically significant difference in image quality among different reconstruction algorithms(P<0.001).The best image quality with the lowest standard deviation,the highest signal noise ratio and contrast-to-noise ratio(CNR)was shown in the I4ls group.The I4ls group showed the highest accuracy and sensitivity for the mild emphysema.The I80s group showed the highest accuracy and specificity for the moderate emphysema.The B4ls and I4ls for severe emphysema were consistent in accuracy.There was significant difference in wall thickness between mild and severe emphysema,and between moderate and severe emphysema(P=0.01,P=0.04,respectively).There were significant differences in lumen area percentage(Ai%)and wall area percentage(WA%)among three groups(P=0.002).The severity of emphysema was negatively correlated with Ai%(r=-0.51)and positively correlated with WA%(r=0.5),respectively.Conclusion Early screening of emphysema in the elderly doing physical examination via chest LDCT is feasible,and the accuracy of IRIS algorithm for quantitative assessment of emphysema severity and small airway lesions is significantly better than that of FBP.

关 键 词：低剂量CT 滤波反投影 基于图像域迭代 肺气肿 小气道病变 

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] R563[医药卫生—临床医学]