基于CT的肺容量测算法在早发性脊柱侧弯诊疗中的应用

The application of CF-based pulmonary volumetric evaluation in the diagnosis of early onset scoliosis

目的通过对比基于CT的肺容量测算结果与常规肺功能检查结果之间的相关性，评估CT测量肺容量法的可靠性和临床意义。方法选取北京儿童医院骨科入院治疗的共计4（）例早发性胸段脊柱侧弯患儿，行肺功能检查和CT检查。应用手绘-分层测量求和法测量患儿肺容量并计算其与预计值之间比例。将结果与患儿常规肺功能结果进行对比，利用文献报道的CT测量的肺容量正常值作为标准数据，比较基于CT的肺容量实测值／预计值与肺功能相应结果的相关性；比较Cobb’S角与凹侧、凸侧肺容量比及肺功能结果之间关系。结果基于CT肺容量结果最大肺活量（VCmax）、用力肺活量（FVC）、肺总量（TLC）平均值低于肺功能检查结果。但与常规肺功能结果的相关性具有统计学意义：VCmax（P〈0．001）、FVC（P（0．001）、TLC（P〈0．001）；基于CT的肺容量实测值／预计值比例与肺功能结果相关性均有统计学意义：Vcmax％（P〈0．001）、FVC％（P〈0．001）、TLC％（P〈0．001）；Cobb’s角与凹侧、凸侧肺容量比及肺功能结果均无明显关联。结论基于CT的肺容量测算法测量的肺容积结果与常规肺功能结果高度相关，是临床评估患儿肺脏容积的一种有效方法。

Objective To evaluate the accuracy of the application of CT-based pulmonary volumetric evaluation to diagnose early onset scoliosis. Methods Forty patients with early-onset thoracic scoliosis were enrolled in this study. All patients had CT scan and pulmonary function test （PFT）. Handdraw-layers summation method was carried out to calculate patients＇ lung volume on CT scan. The reference CT-based lung volume was defined as the commonly accepted data reported in literatures. The ratio of CT-based patients＇ lung volume to the reference CT-based lung volume was calculated. The correlation between the calculated ratio and corresponding PFT results was analyzed statistically. The correlations between Cobb＇s angle and concave/convex lung＇s volume and PFT results were also analyzed. Results Compared to the lung volume of VCmax, FVC, TLC evaluated by PFT, the CT-based lung volume was underestimated. However, the correlation of the lung volume estimated by 2 methods was significant. No significant correlation was found between Cobb＇s angle or concave/convex lung＇s volume and PFT results. Conclusions Conclusions CT-based Pulmonary Volumetric Evaluation is a useful way to evaluate the lungs volume and diagnose early onset scoliosis.