特发性肺纤维化薄层MSCT征象与肺功能的相关性

Idiopathic pulmonary fibrosis: Correlation between thin-section MSCT findings and pulmonary function test results

目的探讨特发性肺纤维化(IPF)薄层MSCT表现特征与肺功能检查诸项指标之间的相关性。方法对临床病理证实的IPF患者30例行薄层MSCT扫描,观察薄层MSCT征象及其解剖分布,对薄预定层面的各征象累及范围进行评分统计。对薄层MSCT各征象与肺功能诸项指标进行相关性分析。结果 30例IPF患者均表现为限制性通气功能障碍。薄层MSCT各征象总的半定量评分与肺活量(VC)、肺总量(TLC)、残气量、用力肺活量、第1秒用力呼气容积、肺一氧化碳弥散量和弥散常数均呈负相关(r=-0.646、-0.661、-0.415、-0.624、-0.483、-0.732、-0.504,P均<0.05),与限制性通气功能分级和弥散功能分级之间呈正相关(r=0.843、0.838,P均<0.001)。VC、TLC与网织影、蜂窝肺呈负相关(r=-0.621、-0.688、-0.387、-0.456,P均<0.05)。结论 IPF薄层MSCT半定量评分与肺功能之间存在较强相关性,分析薄层MSCT征象有助于预测肺功能。

Objective To assess the correlation between thin-section MSCT findings and pulmonary function test results of idiopathic pulmonary fibrosis （IPF）. Methods Thirty patients with clinically and/or pathologically proved IPF under- went thin-section MSCT. The presence and anatomic distribution of thin-section MSCT were assessed, and the extent of abnormal parenchyma was scored at pre-selected levels. The correlation between thin-section MSCT score and the values of pulmonary function tests was examined. Results The pulmonary function tests revealed restrictive ventilatory defect in all the patients. The total scores in thin-section CT negatively correlated with vital capacity （VC）, total lung capacity （TLC）, residual volume, forced inspiratory vital capacity, forced expiratory volume in one second, DLCO and DLCO/VA （r= --0. 646, --0. 661, --0. 415, --0. 624, --0. 483, --0. 732,--0. 504, all P〈0.05）, positively correlated with degrees of restricted ventilation function disturbance and diffuse function changes the lung （r= 0. 843, 0. 838, all P〈0. 001）, while VC, TLC negatively correlated with reticular structures and honeycombing （r=--0. 621, --0. 688, --0. 387, --0. 456, all P〈0.05）. Conclusion Thin-section MSCT can provide significant information for assessment of pathologic severity of idi- opathic pulmonary fibrosis. There is good correlation between thin-section MSCT findings and pulmonary function tests re sults.