摘要
目的 评价低剂量MSCT定量成像技术对吸烟患者肺功能检测的可行性。方法选择临床诊断为慢性阻塞性肺疾病(COPD)患者146例,其中吸烟者109例(74.6%),不吸烟者37例(25.3%),通过常规肺功能检查及低剂量MSCT检查,在最大吸气末及最大呼气末屏气扫描,所有数据通过肺计算机辅助检查系统软件进行分割计算,使用Pearson方法分析吸烟患者与非吸烟患者的低剂量MSCT肺功能参数的差异性及吸烟患者低剂量MSCT肺功能参数与常规肺功能参数的相关性。结果吸烟患者深吸气末肺容积(Vin)为(5125±862)ml,平均肺衰减值为(-902±26)HU,单位体积密度为(0.0984±0.0260)g/cm2,肺气肿体积为(2890±1370)ml;深呼气末肺容积(Vex)为(2756±1027)ml,平均肺衰减值为(-811±62)HU,单位体积密度为(0.1878±0.0631)g/cm2,肺气肿体积为(685±104)ml。非吸烟患者Vin为(3734±759)ml,平均肺衰减值为(-876±40)HU,单位体积密度为(0.1244±0.0401)g/cm2,肺气肿体积为(1503±1217)ml;Vex为(1770±679)ml,平均肺衰减值为(-765±56)HU,单位体积密度为(0.2360±0.0563)g/cm2,肺气肿体积为(156±45)ml。吸烟者与非吸烟者低剂量MSCT肺功能检查各指标差异均有统计学意义(P〈0.01)。吸烟患者低剂量扫描MSCT肺功能参数与常规肺功能参数相关性显示:Vin与肺总量(TLC)有相关性(r=0.58,P〈0.01),Vex与残气量(RV)有相关性(r=0.59,P〈0.01),Vex/Vin与RV/TLC有相关性(r=0.60,P〈0.01),以促发阈值为一950HU时的吸气末像素指数(PI-950in)与第1秒用力呼气量预测值(FEV1%pre)及FEV1/用力肺活量预测值(FVC%)均有相关性(r值分别为-0.53、-0.62,P值均〈0.01);呼气末(PI.950ex)与FEV1%pre及FEV1/FVC%均有相关性(r值分别为-0.71、-0.77,P值均〈0.01)。结论低剂量MSCT肺功能检查能很好地评估吸烟患者的肺功能情况,可作为临床评估吸烟患者肺功能的一种新的检查方法。
Objective To evaluate the clinical feasibility of low dose MSCT for quantitative assessment of pulmonary function in smokers. Methods One hundred and forty-six patients with chronic objective pulmonary disease ( COPD ) including 109 smokers (74. 6% ) and 37 non-smokers ( 25.3% ) underwent pulmonary function test and low-dose MSCT scan. All data were analyzed using computer-aided lung analysis software. Pulmonary function parameters from low-dose MSCT were compared between smokers and non-smokers and also compared with pulmonary function test in non-smokers (Pearson test). Results In smokers, the average volume at full inspiratory phase (Vin) was (5125 ±862 )ml, mean lung attenuation was ( -902 + 26) HU, mean lung density was (0. 0984 ± 0. 0260) g/cm3, emphysema volume was (2890 ± 1370) ml. The average volume at full expiratory phase (Vex) was (2756± 1027) ml,mean lung attenuation was ( -811±62) HU,mean lung density was (0. 1878 ±0. 0631) g/cm3 ,emphysema volume was (685 ± 104) ml. In non-smokers, the average Vin was (3734± 759) ml, mean lung attenuation was ( -876± 40) HU, mean lung density was (0. 1244 ±0. 0401 ) g/cm3, emphysema volume was ( 1503 ± 1217 ) ml. The average Vex was ( 1770 ±679 ) ml, mean lung attenuation was ( - 765±56 ) HU, mean lung density was (0. 2360 ±0. 0563 ) g/era3, emphysema volume was ( 156 ± 45 ) ml. There were significant differences between smokers and non-smokers (P 〈 0. 01 ). The Vex/Vin was correlated with residual volume/total lung capacity ( RV/TLC, r = 0.60, P 〈 0.01 ) , and Vin was correlated with TLC ( r = 0. 58, P 〈 0.01 ) , Vex with RV ( r = 0. 59, P 〈 0. 01 ). Pixel index(PI) -950in was correlated with FEV1% pre and FEV1/FVC% ( r = - 0. 53, - 0. 62, respective, P 〈 0. 01 ) ,PI-950ex was correlated with FEV1% pre and FEV1/FVC% ( r = - 0. 71, - 0. 77,respective,P 〈 0.01 ). Conclusion Low-dose MSCT can be a potential imaging tool for quantitative pulmonary function assessment in smokes.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第5期405-409,共5页
Chinese Journal of Radiology
基金
广东省科技计划项目(2008-83049)
广州医学院第一附属医院科研基金立项项目(y200912gyfy)