基于HRCT图像对纤维化性间质性肺疾病与慢性阻塞性肺疾病的肺容积定量的比较研究  

A comparative study of lung volume quantification between fibrotic interstitial lung disease and chronic obstructive pulmonary disease based on HRCT images

作　　者：杨晓娜 周嘉鑫 陆海琴 张怀 孙潇[2] 朱力[2] YANG Xiao-na;ZHOU Jia-xin;LU Hai-qin;ZHANG Huai-rong;SUN Xiao;ZHU Li(Clinical Medical College of Ningxia Medical University,Yinchuan 750004,China;Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750003,China)

机构地区：[1]宁夏医科大学研究生院,宁夏银川750004 [2]宁夏医科大学总医院放射科,宁夏复银川750003

出　　处：《中国临床医学影像杂志》2024年第11期782-786,共5页Journal of China Clinic Medical Imaging

基　　金：国家重点研发计划项目(2022YFC2010003);宁夏重点研发计划项目(2023FRD05010)。

摘　　要：目的:比较纤维化性间质性肺疾病(F-ILD)与慢性阻塞性肺疾病(COPD)中反映病变肺容积的CT定量参数并观察其与肺功能指标的相关性。方法:回顾性分析所有患者资料;包括F-ILD患者76例,以第1秒用力呼气容积率(FEV1%)预测值(预测值在±1%以内)1∶1匹配COPD患者76例,年龄、性别匹配的健康对照组70例;分析CT定量参数包括全肺容积、低衰减区百分比(LAA%)、高衰减区百分比(HAA%)及总肺破坏面积百分比(DLA%),肺功能参数包括用力肺活量(FVC%)、FEV1%、总肺活量(TLC%)、一氧化碳弥散能力(DLco%)及综合生理指数(CPI);采用受试者工作特征(ROC)曲线分析基于视觉评估和CT定量参数反应肺气肿和肺纤维化的诊断效能。结果:肺功能指标FVC%pred在各组间具有差异性,DLco%pred及TLC%pred在F-ILD与COPD组间具有差异性,相比于健康对照组,FEV1%pred在各组间具有差异性(P均<0.05);F-ILD组全肺容积明显低于其他各组,HAA%明显高于其他各组,COPD组LAA%明显高于其他各组,健康对照组DLA%明显低于其他各组(P均<0.05);LAA%和HAA%分别对肺气肿和肺纤维化的检测具有高敏感性和高特异性(LAA%:AUC=0.835;HAA%:AUC=0.934);LAA%、HAA%及DLA%与肺功能指标呈负相关,与CPI呈正相关(P均<0.05);在COPD组、F-ILD组及所有患者中,DLA%与DLco%呈显著负相关(P均<0.05);在F-ILD组,DLA%与CPI呈显著正相关(P均<0.05)。结论:定量CT参数LAA%、HAA%及DLA%与肺功能相关,能客观反映F-ILD与COPD患者异常肺容积,另外对肺气肿与肺纤维化有较好的诊断效能。Objective: To compare the CT quantitative parameters reflecting the lesion involved lung volume in fibrotic interstitial lung disease(F-ILD) and chronic obstructive pulmonary disease(COPD), and to observe their correlation with lung func-tion indexes. Methods: The data of all patients were retrospectively analyzed. Including 76 patients with F-ILD, 76 patients with COPD were matched with forced expiratory volume in one second(FEV1%) predicted value(predicted value within ±1%) 1∶1, and 70 healthy controls were matched with age and sex. The differences and correlations between CT quantitative parameters and lung function parameters were analyzed. CT quantitative parameters included total lung volume, percentage of low attenuation area(LAA%), percentage of high attenuation area(HAA%) and percentage of total lung destruction area(DLA%), while lung function parameters included forced vital capacity(FVC%), FEV1%, total lung capacity(TLC%), carbon monoxide diffusion capacity(DLco%) and comprehensive physiological index(CPI). The receiver operating characteristic(ROC) curve was used to ana-lyze the diagnostic efficacy of CT quantitative parameters based on visual assessment. Results: The lung function index FVC%pred was different between the groups. DLco%pred and TLC%pred were different between F-ILD and COPD groups. Compared with the healthy control group, FEV1%pred was different between the groups(P<0.05). The whole lung volume in F-ILD group was significantly lower than that in other groups, HAA% was significantly higher than that in other groups, LAA% in COPD group was significantly higher than that in other groups, and DLA% in healthy control group was significantly lower than that in other groups(all P< 0.05). LAA% and HAA% had high sensitivity and specificity for the detection of emphysema and pulmonary fibrosis, respectively(LAA%: AUC=0.835;HAA%: AUC=0.934);HAA% and DLA% were negatively correlated with lung function indexes and positively correlated with CPI(all P<0.05). There was a significant negative correl

关 键 词：肺疾病 间质性 肺疾病 慢性阻塞性 体层摄影术 螺旋计算机 

分 类 号：R563.13[医药卫生—呼吸系统] R814.42[医药卫生—内科学]