螺旋CT肺密度测定软件在放射性肺损伤中的应用

Assessment of lung density detecting software in patients with radioactive lung injury by MDCT

目的应用螺旋CT肺密度测定软件,根据肺密度变化,找出与放射性肺损伤之间的相关因素,探讨其应用价值。方法经常规CT诊断的96例不同类型的放射性肺损伤和80例正常体检者采用16排螺旋CT附带的pulmo自动评价软件测定肺尖、肺门、横膈区的平均CT值,将CT片上放射性肺损伤分型、分类,对其肺密度值进行测定。结果96例不同类型的放射性肺损伤中,56例平均肺密度有不同程度的升高,以含气不全型及慢性纤维化型最为明显。急性放射性肺炎磨玻璃期和补丁期因受累范围和时间关系,肺密度CT值影响不大,35例放射性肺损伤肺密度测定在正常范围。对不同类型的放射性肺损伤肺密度正常与异常值的比较,差异有非常显著性(χ2=56.718,P<0.001)。80例正常体检中68例平均肺密度值正常,12例平均肺密度异常。放射性肺损伤组与正常组的肺密度比较,差异有非常显著性(χ2=18.027,P<0.001)。结论螺旋CT肺密度测定能准确评价不同类型放射性肺损伤的肺密度值,判断肺密度与各型放射性肺损伤之间的相关性。对各种不同类型放射性肺损伤的诊断、定位、照射剂量的掌握具有较高的价值。

Objective To evaluate lung density variation in radioactive lung injury by lung density detecting software of helical CT. Methods The software named plume on MDCT were applied in lung density measurement in 96 cases of different kinds of redioactive lung injury and 80 cases of normal lungs. The ALD were the average CT values of the 3 zones of lungs named lung apex,hilus and diaphragm. The radioactive lung injuries were classified by their CT appearance. The ALD of the normal group and radioactive lung injury group,as well as the ALD in different sorts of radioactive lung injury were valued. Results 56 in 96 cases of radioactive lung injury had different extent of higher lung density compared with normal cases. The semi-gaseous and chronic fibrosis groups had higher lung density than other groups. The ground glass lesions or the patch lesions of acute radioactive lung injury had similar lung density. The lung density of 35 cases of radioactive lung injury was in normal range of lung density. The ALD of different kinds of radioactive lung injury were different statistically （χ^2=56. 718,P〈0. 001）. In normal lungs group, 68/80 had normal ALD. The ALD between the radioactive lung injury group and normal group were significantly different （χ^2==18. 027,P〈0. 001）. Conclusion MDCT can correctly assess the lung density of different kinds of radioactive lung injury, and can judge the sorts of radioactive lung injury by lung density. The method is very useful in localization and diagnosis of different radioactive lung injuries,and can help with controlling radiation dose.