肺高分辨率薄层CT征象与支气管狭窄分级间关系及对治疗效果的预估价值  

Analysis of the relationship between the high resolution thin slice CT signs of the lung and the classification of bronchial stenosis and the predictive value of the therapeutic effect

作　　者：柯涛 张慧 樊华 蔡迎彬 KE Tao;ZHANG Hui;FAN Hua;CAI Yingbin(Endoscopic Diagnosis and Treatment Center of Cancer Hospital Affiliated to Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学附属肿瘤医院内镜诊治中心,新疆乌鲁木齐830054

出　　处：《医学影像学杂志》2024年第2期27-32,共6页Journal of Medical Imaging

基　　金：新疆维吾尔自治区自然科学基金(编号:2020D01C315)。

摘　　要：目的 探讨高分辨率薄层CT征象与支气管狭窄分级间关系及对治疗效果的预估价值。方法 选取我院支气管狭窄患者128例,均进行高分辨率薄层CT扫描。采用多元有序Logistic回归分析高分辨率薄层CT征象与支气管狭窄分级间关系,并根据治疗效果分为有效组、无效组。分析治疗效果的影响因素,采用受试者操作特征曲线(ROC曲线)分析高分辨率薄层CT征象对治疗效果的预估价值。结果 128例支气管狭窄患者轻度33例,中度57例,重度38例,不同支气管狭窄分级患者高分辨率薄层CT征象比较,差异有统计学意义(P<0.05);结节互相融合、支气管开口扭曲变形、管腔变细,甚至闭塞、终末细支气管囊状扩张是支气管狭窄分级增加的独立危险因素(P<0.05);128例患者治疗有效102例(79.69%),无效26例(20.31%),建立Logistic回归模型:logit(P)=-5.714-1.102×边界清晰+1.155×胸膜增厚+1.044×结节互相融合,基于高分辨率薄层CT征象的Logistic回归模型对治疗效果的预估AUC为0.812,95%CI为0.733~0.875,χ^(2)为6.858,敏感度为80.77%,特异度为68.63%。结论 高分辨率薄层CT征象与支气管狭窄分级关系密切,可为临床早期评估治疗效果提供参考。Objective To investigate the relationship between the signs of high resolution thin slice CT and the classification of bronchial stenosis,and the predictive value of the therapeutic effect.Methods A total of 128 patients with bronchial stenosis in our hospital from January 2021 to December 2021 were selected.High-resolution CT thin-section scans were performed.Multivariate ordinal logistic regression was used to analyze the relationship between high-resolution CT thin-section signs and bronchial stenosis grades,and the patients were divided into effective and ineffective groups according to the treatment effect.The influencing factors of the treatment effect were analyzed,and the receiver operating characteristic curve(ROC curve)was used to analyze the predictive value of the high-resolution CT thin-section sign on the treatment effect.Results Among the 128 patients with bronchial stenosis,33 were mild,57 were moderate,and 38 were severe.There were significant differences in high-resolution CT thin-section signs among patients with different bronchial stenosis grades(P<0.05).Mutual fusion of nodules,distortion of bronchial openings,thinning or even occlusion of lumen,and cystic dilatation of terminal bronchioles were independent risk factors for increased grades of bronchial stenosis(P<0.05).Of the 128 patients,102(79.69%)were effective,and 26(20.31%)were ineffective.Logistic regression model was established:logit(P)=-5.714-1.102×clear border+1.155×pleural thickening+1.044×nodules fused with each other.The logistic regression model based on high-resolution CT thin-section sign predicted the treatment effect with an AUC of 0.812,a 95%CI of 0.733-0.875,a χ^(2) of 6.858,a sensitivity of 80.77%,and a specificity of 68.63%.Conclusion The high-resolution CT thin-section sign is closely related to the bronchial stenosis grade,which can provide a reference for early clinical evaluation of the treatment effect.

关 键 词：支气管狭窄 受试者操作特征曲线 高分辨率 体层摄影术 X线计算机 

分 类 号：R562.2[医药卫生—呼吸系统] R814.42[医药卫生—内科学]