CT三维成像技术在儿童哮喘小气道病变评估中的价值研究  

Exploration for the value of CT-3D imaging technique in assessing SAD of asthma

作　　者：陈艳萌 彭开珍 孙经纬 Chen Yanmeng;Peng Kaizhen;Sun Jingwei(Department of Pediatric,The First Affiliated Hospital with Nanjing Medical University,Nanjing 210000,China;Imaging Department,The First Affiliated Hospital with Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学第一附属医院儿科,南京210000 [2]南京医科大学第一附属医院影像科,南京210000

出　　处：《中国医学装备》2025年第4期48-52,共5页China Medical Equipment

基　　金：江苏省科研基金资助项目(2021JH031400)。

摘　　要：目的:探讨CT三维成像技术在儿童哮喘小气道病变(SAD)评估中的临床价值。方法:选取2021年9月至2024年8月江苏省人民医院收治的104例疑似SAD患儿,根据肺通气功能检测结果是否正常将其分为病变组(48例,小气道堵塞)和对照组(56例,肺通气功能无异常)。两组患儿均行肺通气功能检测与呼吸双相CT扫描,观察高分辨力CT(HRCT)图像表现,分析其与肺通气功能测定相关指标最大呼气中期流速(MMEF25%~75%)、75%肺活量时用力呼气流量(FEF75%)、50%肺活量时用力呼气流量(FEF50%)、25%肺活量时用力呼气流量(FEF25%)和第1秒用力呼气容积(FEV1)的相关性。结果:病变组MMEF25%~75%、FEF75%、FEF50%、FEF25%及FEV1均较对照组明显下降,两组比较差异有统计学意义(t=8.735、12.757、9.724、13.928、10.303,P<0.05)。病变组HRCT征象中支气管壁增厚、空气潴留、马赛克征及细支气管阻塞的发生率均明显高于对照组,两组比较差异有统计学意义(x^(2)=10.715、6.119、6.330、6.587,P<0.05)。细支气管壁增厚与MMEF25%~75%、FEF75%、FEF50%、FEF25%及FEV1之间均存在明显相关性(r=-0.360、-0.379、-0.374、-0.367、-0.268,P<0.001),尤其是与FEF75%的相关性极强。空气潴留与FEF75%、FEV1之间相关性显著(r=-0.249、-0.240,P<0.05)。马赛克征与MMEF25%~75%、FEF75%和FEV1均表现出明显相关性(r=-0.236、-0.245、0.257,P<0.05)。细支气管阻塞与MMEF25%~75%、FEF75%、FEF50%以及FEV1均显著相关(r=-0.248、-0.271、-0.253、-0.275,P<0.05)。病变组哮喘发生率为60.42%,明显高于对照组的5.36%,两组比较差异有统计学意义(x^(2)=36.783,P<0.05)。结论:SAD患儿HRCT征象细支气管壁增厚、空气潴留、马赛克征及细支气管阻塞发生率明显升高,且与肺通气功能指标尤其是FEF75%、FEV1等具有极高相关性,一定程度上反映小气道功能,对识别早期SAD具有重要价值,而CT三维成像技术在SAD患儿中的应用对哮喘的发生有一定的预Objective:To explore the clinical value of computed tomography-three-dimensional(CT-3D)imaging technique in assessing small airway disease(SAD)in children with asthma.Methods:A total of 104 pediatric patients with suspected SAD,who admitted to our hospital from September 2021 to August 2024,were selected,and they were divided into lesion group(48 cases,with obstruction in small airway)and control group(56 cases,lung function without abnormality)according to the results of test for pulmonary function.Both two groups underwent test for lung function and respiratory biphasic CT scan,and the manifestations of high resolution CT(HRCT)image were observed.The correlation between the SAD and the relative indicators of determining ventilation function of lung,which included maximum mid-expiratory flow(MMEF25-75%),forced expiratory flow at 75%vital capacity(FEF75%),forced expiratory flow at 50%vital capacity(FEF 50%),forced expiratory flow at 25%vital capacity(FEF25%)and forced expiratory volume at the first second(FEV1),was analyzed.Results:The MMEF25-75%,FEF75%,FEF50%,FEF25%and FEV1 in the lesion group were significantly lower than those of the control group(t=8.735,12.757,9.724,13.928,10.303,P<0.05).The incidences of bronchial wall thickening,air retention,Mosaic sign and bronchiole obstruction of HRCT signs of the lesion group were significantly higher than those of the control group(x^(2)=10.715,6.119,6.330,6.587,P<0.05).Bronchial wall thickening significantly correlated with MMEF25-75%,FEF75%,FEF50%,FEF25%and FEV1(r=-0.360,-0.379,-0.374,-0.367,-0.268,P<0.001),respectively,and the correlation between it and FEF75%was extremely strong.Air retention significantly correlated with FEF75%and FEV1(r=-0.249,-0.240,P<0.05),respectively.The Mosaic sign significantly correlated with MMEF25-75%,FEF75%and FEV1(r=-0.236,-0.245,0.257,P<0.05),respectively.Bronchial obstruction significantly correlated with MMEF25-75%,FEF75%,FEF50%and FEV1(r=-0.248,-0.271,-0.253,-0.275,P<0.05),respectively.The incidence of asthma in the lesion group

关 键 词：小气道病变(SAD) 多层螺旋CT 哮喘 儿童 

分 类 号：R816.4[医药卫生—放射医学]