定量CT预测内科胸腔镜下巨型肺大疱减容术疗效  

Quantitative CT for predicting efficacy of medical thoracoscopic giant emphysematous bullae volume reduction

作　　者：梁婷婷 余耀华 李振华 李国燕 张新娜 张华 LIANG Tingting;YU Yaohua;LI Zhenhua;LI Guoyan;ZHANG Xinna;ZHANG Hua(Postgraduate School of Xinxiang Medical University,Xinxiang 453000,China;Department of Respiratory and Critical Care Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]新乡医学院研究生院,河南新乡453000 [2]郑州大学附属郑州中心医院呼吸与危重症医学科,河南郑州450000

出　　处：《中国医学影像技术》2023年第12期1819-1822,共4页Chinese Journal of Medical Imaging Technology

基　　金：河南省医学科技攻关计划项目(LHGJ20220856)。

摘　　要：目的观察定量CT(QCT)用于预测内科胸腔镜下巨型肺大疱(GEB)减容术疗效的价值。方法回顾性分析26例接受内科胸腔镜下GEB减容术的慢性阻塞性肺疾病(COPD)合并GEB患者,对比治疗前及治疗后6个月胸部QCT及肺功能检查资料;根据治疗后6个月肺功能[第1秒用力呼气容积(FEV_(1))]相比治疗前的改善率将患者分为显著改善组(FEV_(1)改善率≥15%,n=20)与非显著改善组(FEV_(1)改善率<15%,n=6),比较治疗前组间QCT参数差异,分析治疗后6个月FEV_(1)改善程度与组间差异有统计学意义参数的相关性;绘制受试者工作特征(ROC)曲线,评估各参数预测内科胸腔镜下减容术治疗GEB效果的效能。结果治疗前靶肺叶容积、全肺肺容积及肺大疱容积组间差异均有统计学意义(P均<0.05)。治疗前靶肺叶肺容积、全肺肺容积、靶叶肺大疱容积、全肺肺大疱容积与FEV_(1)改善均呈正相关(r/r_(s)=0.600、0.470、0.699、0.523,P均<0.05),以各参数预测FEV_(1)改善的曲线下面积依次为0.817、0.817、0.892及0.833(P均<0.05)。结论QCT能有效预测内科胸腔镜下GEB减容术疗效。Objective To observe the value of quantitative CT(QCT)for predicting the efficacy of medical thoracoscopic giant emphysematous bullae(GEB)volume reduction.Methods Data of chest QCT and pulmonary function tests before and 6 months after medical thoracoscopic volume reduction in 26 chronic obstructive pulmonary disease(COPD)patients complicated with GEB who underwent medical thoracoscopic GEB volume reduction were retrospectively analyzed.According to the improvement rate of lung function(forced expiratory volume in one second[FEV_(1)])6 months after treatment compared with that before treatment,the patients were divided into significant improvement group(FEV_(1)improvement rate≥15%,n=20)and non-significant improvement group(FEV_(1)improvement rate<15%,n=6).QCT parameters before treatment were compared between groups,and the correlations of QCT parameters being significantly different between groups with FEV_(1)improvement 6 months after treatment were analyzed.Then receiver operating characteristic(ROC)curves were drawn to evaluate the efficacy of the above parameters for predicting the curative effect of medical thoracoscopic volume reduction of GEB.Results Significant differences of preoperative target lung lobe volume,total lung volume and bullae volume were found between groups(all P<0.05).Preoperative target lung lobe volume,total lung volume,target lobar bullae volume and total lung bullae volume were positively correlated with FEV_(1)improvement(r/r_(s)=0.600,0.470,0.699,0.523,all P<0.05),with the area under the curve(AUC)for predicting FEV_(1)improvement of 0.817,0.817,0.892 and 0.833(all P<0.05),respectively.Conclusion QCT could effectively predict the efficacy of medical thoracoscopic GEB volume reduction.

关 键 词：肺疾病 慢性阻塞性 内镜下肺减容术 体层摄影术 X线计算机 

分 类 号：R563.3[医药卫生—呼吸系统] R814.42[医药卫生—内科学]