振动反应成像技术在弥漫性肺实质病的应用初探

Exploration of vibration response imaging in evaluating diffuse parenchymal lung disease

目的初步探讨振动反应成像(VRI)检查在弥漫性肺实质疾病(DPLD)中的图像特点,进而总结其临床应用价值。方法选择2010年7月-2011年2月期间在北京协和医院呼吸科住院的胸部影像学表现为双下肺索条、网格、蜂窝影的DPLD患者35例做为实验组,同期招募健康成年人33例作为对照组。VRI设备采用VRIxp系统,按照研究步骤(问诊、查体、VRI检查等)采集两组人员临床及VRI信息。采用非参数检验以及t检验等统计学方法,对DPLD组及正常对照组的VRI图像特点,包括振动能量曲线、动态图像发展、MEF面积、左肺QLD值、干湿啰音监测等方面进行分析。结果 DPLD组振动曲线评分和动态图像发展评分显著高于对照组[2(1～3)vs 0(0～1);3(2～4)vs 0(0～1)](P<0.05),其中DPLD组观察动态图像发展,可见吸气相能量团显著向中下移心而双上肺能量缺失。两组MEF面积及左肺QLD值无显著差异[(71.13±4.94)vs(71.61±3.42);(54.31±11.34)%vs(56.70±6.02)%];DPLD组VRI监测的干湿啰音与听诊符合度为89%。结论 VRI中振动曲线异常、动态图像发展特点对于探测DPLD有一定价值。

Objective To explore the value of vibration response imaging （VRI） system in evaluating the patients with diffuse parenchymal lung disease （DPLD）. Methods 35 DPLD patients whose CT results show reticulation and honeycombing at the lung bases and 33 healthy volunteers were enrolled. Both clinical examination and VRI test were performed. Parameters of VRI were measured, including vibration energy graph grades, dynamic image grades, areas of Maximal energy frame （MEF）, quantitative lung data（QLD） and rales. The statistical analysis was performed using 2 Independent Samples Tests and Independent-Samples T test. Results The VRI parameters of the DPLD group were as follows：graph grades of 2 （1 -3 ）, dynamic image grades of 3 （2 -4）, MEF areas of （71.13± 4. 94） kilo-pixels, QLD of （ 54. 31 ± 11.34 ） % （left）. The VRI parameters of the control group were as follows ： graph grades of 0（0 - 1 ） ,dynamic image grades of 0（0 - 1 ）, MEF areas of （71.61 ±3.42） kilo-pixels, QLD of （ 56. 70 ± 6. 02 ） % （left）. There was significant difference between the two groups in graph grades and dynamic iraagegrades （P 〈 0. 05 ）, yet no significant difference was shown in MEF areas and QLD. Energy moved down during inspiration in DPLD patients. Rale detectation by VRI was consistent with auscultation in 89% suhiects.Conclusions outcomes including graph and dynamic image characteristics is a potential method to evaluate DPLD.VRI outcomes including graph and dynamic image characteristics is a potential method to evaluate DPLD.