螺旋CT对慢性阻塞性肺疾病急性加重期的诊断价值

Studies on Chronic Obstructive Pulmonary Disease with Acute Exacerbation by Spiral CT

目的探讨慢性阻塞性肺疾病急性加重期(chronic obstructive pulmonary disease with acute exacer-bation,AECOPD)患者的CT图像特征,并测量右肺上叶尖段支气管的管壁厚度,为诊治提供影像学基础。方法选取AECOPD患者30例、体检正常者30例和经临床诊断为COPD稳定期患者30例,分析其CT征象;使用MPR技术重建右肺上叶尖段支气管垂直的层面的断面图像,测出管壁的内径(L)、外径(D),计算出气道壁的厚度和外径之比(TDR)、气道壁的面积占气道总横截面积的百分比(WA%)。结果 AECOPD组患者的支气管壁较COPD组及对照组增厚,各组间WA%、TDR差异均有显著性(P<0.05);COPD组患者支气管管壁较正常对照组明显增厚,各组间WA%、TDR差异均有显著性(P<0.05)。结论 64排螺旋CT可以较真实、直观地评估AECOPD及COPD患者的气道直径、气道重构与气流受限的关系,TDR、WA%能够作为评估AECOPD、COPD气流受限敏感的指标。

objective To investigate CT image characteristics for patients with chronic obstructive pulmonary disease in acute aggravating period(AECOPD)while determing the wall thinkness of bronchial tube for the upper blade tip segment so as to provide basis for treatment.Methods CT signs for 30 cases with AECOPD,30 normal controls and 30 cases with COPD in stationary were analyzed;the upper blade tip segment was reconstructed by reconstruction bronchial vertical section image to determine the inner diameter of pipe wall(L)and outer diameter(D).And according to these data airway wall thichness,ratio of diameters(TDR)and percentage between airway wall area and total airway cross sectional area(WA%) were calculcted.Results AECOPD bronchial wall was more thickened than that of COPD controls.Meanwhile,there were a significant difference in WA% and TOR among the groups(P&lt;0.05);COPD bronchial wall was more thickened than that of normal controls obviously,there were significant differences in WA%,TDR among the groups(P&lt;0.05).Conclusion 64-row helical CT is reliable and direct to value the airway diameter,airway remodelling and airflow restricted relations for patients with AECOPP and COPD and TDR,and WA% could be used as sensitive indicators for evaluating AECOPD,COPD.