特发性肺纤维化高分辨CT征象与肺功能的相关性

Idiopathic pulmonary fibrosis:correlation between helical CT findings and pulmonary function test results

目的探讨特发性肺纤维化(IPF)患者的螺旋CT表现特征与肺功能的相关性。方法经临床病理证实的28例IPF患者进行吸气后屏气HRCT扫描,并进行肺功能测定,观察IPF的CT征象及其解剖分布,评价CT表现特征与肺功能损害的关系。结果28例IPF均有不同程度的限制性通气功能障碍。肺HRCT扫描出现最多的征象是网格影(92.8%)、蜂窝影(82.6%);磨玻璃影与FEV1、FEV1/FEV轻度负相关,网格影与DLco显著负相关,蜂窝影和CT总评分与FVC、FEV1、TLC和DL-co均具有很好的负相关性。结论螺旋CT能准确反应IPF的病理变化,IPF不同程度的肺功能受损与螺旋CT征象存在相关性。两者相结合有助于预测IPF的进展、预后以及疗效反应。

Objective To determine the correlation between helical CT findings and pulmonary function test （PFT）results from patients with idiopathic pulmonary fibrosis （IPF）. Methods Twenty-eight patients were enrolled according to the international diagnostic criterion. HRCT were acquired on multisection CT in supine position during breath holding after inspiration. All patients underwent pulmonary function tests. The correlation between CT findings and pulmonary function test results were assessed. Results Pulmonary function test revealed characteristic restrictive ventilatory defect. The primary HRCT findings were reticular pattern （92. 8 % ）, and honey combing （82. 6% ）. Ground-glass opacities were weak but significantly negatively correlated with FEV1 , FEV1/FEV. The significant negative correlation was found between reticular pattern and DLco. Honeycombing and CT score were significantly negatively correlated with FVC, FEVI, TLC and DLco. Conclusion CT can provide significant information for the assessment of the pathologic severity of idiopathic pulmonary fibrosis. There is significant correlation between CT findings and pulmonary function test results. CT combined with pulmonary function test can predict the progression, long term survival and response to therapy.