摘要
目的评估呼吸双相CT定量技术评价慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)肺气肿及小气道功能障碍程度的价值。方法研究纳入35例COPD患者(病例组)和32例非吸烟肺功能(Pulmonary Function Test,PFT)正常者(对照组)作为研究对象。在呼吸双相CT上测量肺气肿指数(Emphysema Index,EI)、空气潴留指数(Air Trapping,AT)、吸气相平均肺密度(Inspiration Mean Lung Density,MLD_(in))和呼气相平均肺密度(Expiation Mean Lung Density,MLD_(ex))及二者的比值(E/I_(MLD))、吸气相肺体积(Inspiration Lung Volume,LV_(in))和呼气相肺体积(Expiation Lung Volume,LV_(ex))及二者的比值(E/I_(LV))。比较对照组与病例组、轻中度病例组与重度病例组CT定量参数,并与PFT参数:用力肺活量(Furced Vital Capacity,FVC);1 s用力呼气容积(Forced Expiratory Volume in One Second,FEV_(1))、1 s用力呼气容积占用力肺活量的比值(FEV_(1)/FVC)、最大呼气中期流速(Mid Expiratory Phase of Forced Expiratory Flow,FEF_(25%~75%))、残气容积(Residual Volume,RV)、肺总量(Total Lung Capacity,TLC)、残气容积与肺总量的比值(RV/TLC)进行相关性分析。结果与对照组相比,病例组患者全肺的LV、EI、AT、E/I_(LV)、E/I_(MLD)升高,MLD降低(P<0.05)。轻中度病例组与重度病例组间的LV、EI、AT、E/I_(LV)、E/I_(MLD)、MLD有显著差异(P<0.05),反映肺气肿程度的指标EI与PFT指标FVC%、FEV_(1)%、FEV_(1)/FVC有较高相关性,反映空气潴留指标AT、E/I_(LV)、E/I_(MLD)与PFT中小气道功能指标FEF_(25%~75%)、RV和RV/TLC密切相关。结论COPD患者呼吸双相CT的密度和体积变化与肺气肿的程度及小气道功能障碍密切相关,其中呼气相指标可以更好地反映小气道功能。
Objective To determine the value for the detection and quantification of lung function in chronic obstructive pulmonary disease(COPD)using inspiratory and expiratory CT scans and to assess whether the densitometric parameter can be used for the quantification of the degree of emphysema and small airway dysfunction.Methods A total of 35 COPD patients(case group)and 32 nonsmokers with normal pulmonary function test(PFT)(control group)were included in our study.The emphysema index(EI),the air trapping(AT),expiration/inspiration mean lung density(MLDin/MLDex)and ratio of mean lung density(E/IMLD),expiration/inspiration lung volume(LVin/LVex)and ratio of mean lung density(E/ILV)were measured on CT.The quantitative CT parameters were compared between the control group and the case group as well as between the mild to moderate case group and the severe case group,and the parameters of PFT were as following:furced vital capacity(FVC),forced expiratory volume in one second(FEV1),ratio of forced expiratory volume in one second to forced vital capacity(FEV1/FVC),mid expiratory phase of forced expiratory flow(FEF25%-75%),residual volume(RV),total lung capacity(TLC),ratio of residual air volume to total lung volume(RV/TLC)were correlation analyzed.Results Compared with the control group,LV,EI,AT,E/ILV,E/IMLD were increased and MLD was decreased in case group(P<0.05),and there were significant differences in LV,EI,AT,E/ILV,E/IMLD and MLD between the mild to moderate case group and the severe case group(P<0.05).The EI which reflected the degree of emphysema,showed a higher correlation with FVC%,FEV1%,FEV1/FVC.The AT,E/ILV and E/IMLD which reflected the air retention indexes were closely related to FEF25%-75%,RV and RV/TLC.Conclusion The density and volume changes of inspiratory and expiratory CT in COPD patients are closely related to the degree of emphysema and small airway dysfunction,and the index of expiratory phase can better reflect the small airway function.
作者
格崤
杨学东
罗萍
方继良
史珊
GE Xiao;YANG Xuedong;LUO Ping;FANG Jiliang;SHI Shan(Department of Radiology,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《中国医疗设备》
2022年第10期83-87,共5页
China Medical Devices
关键词
呼吸双相CT
肺功能
慢性阻塞性肺疾病
空气潴留
inspiratory and expiratory CT scans
pulmonary function test
chronic obstructive pulmonary disease
air trapping
