64层螺旋CT肺功能研究及HRCT在肺间质疾病的应用

Study of 64-slice spiral CT in pulmonary function and application of HRCT in interstitial lung disease

目的评价高分辨力CT(HRCT)对肺间质性疾病诊断的作用,并探讨MSCT肺容积指标与肺功能(PFT)指标之间的相关性。方法选择50例临床诊断为间质性肺疾病的患者为病例组,对照组为22例CT胸部体检且肺功能正常者,对比两者间各种指标的差异。同时观察所有对象肺HRCT的细微结构的改变。结果 HRCT易于发现肺部间质性病变的网状阴影、小结节阴影、磨玻璃样阴影、肺气肿和细支气管病变。CT肺容积指标中,最大呼气末容积(Vex)与残气量(RV),最大吸气末容积(Vin)与肺总量(TLC),容积差(Vin-Vex)与用力肺活量(FVC),容积比(Vin/Vex)与残气量及肺总量比(RV/TLC),存在着较好的相关性,r值分别为0.91、0.87、0.65、0.65,P<0.01。结论 HRCT对诊断ILD有很高的价值,MSCT肺容积与PFT容积指标有显著相关性,MSCT肺容积指标能用于临床评价肺功能。

Objective To analyze the action of the high resolution CT in the diagnosis of the interstitial lung disease and to explore the correlation between lung volumes measured by MSCT and Pulmonary function test （PFT）. Methods 50 patients with interstitial lung disease （ ILD group）, and 22 people were nomal who were selected by PFT and chest MSCT （ control group）. The differences between lung volumes parameter measured by MSCT and PFT were compared. The minute structure of lung were observed on HRCT in two groups. Results HRCT was more sensitive in discovering the reticular shadow, micronodular pattern, ground glass pattern, emphysema, bronchiectasis and thickness of bronchiolar wall. The full expiration volume （Vex） significantly correlated with residual volume （RV） as well as the full inspiration volume （Vin） with total lung capacity （TLC）. The value of Vin-Vex significantly correlated with forced vital capacity （ FVC ） , as well as Vex/Vin with RV/TLC. The values of r were 0. 91,0. 87, 0.65 and 0.65, respectively（ P 〈 0. 01 ）. Conclusion High resolation CT （HRCT） has great value in the diagnosis of ILD, especially in the evaluation of the disease severity and effi- cacy of treatment. Lung volumes obtained from MSCT show correlation with PFT results. Lung volumes measured by MSCT can be used to evaluate the pulmonary function.