螺旋CT结合呼吸门控对矽肺形态与功能变化的研究

Silicosis: a study of pulmonary morphology and function with spirometrically controlled quantitative CT

目的 探讨呼吸门控定量CT在评价矽肺形态与功能改变中的应用价值。方法 4 6例矽肺病人在 5 0 %肺活量 (VC)状态下行全肺螺旋CT扫描 ,在 2 0 %VC、80 %VC呼吸水平下于隆突层、隆突上、下各 5cm处行高分辨率CT(HRCT)扫描。用Pulmo软件评估全肺各区间像素指数 (PI) ,并与临床肺功能指标进行相关分析。结果 CT能清晰地显示矽肺的病变特征 ,HRCT能更好地显示肺间质病变。随着期别的增高 ,分布在 <- 910HU(A区间 ,API)和 >- 6 10HU(E区间 ,EPI)的PI增加(P <0 .0 5或P <0 .0 1)。API、EPI与第 1秒用力呼气容积 (FEV1.0 )和VC呈中至高度相关 (r =- 0 .80 1～ 0 .6 90 )。结论 呼吸门控定量CT能反映矽肺形态和功能异常的变化趋势 ,并有利于病变的追踪观察 。

Objective To evaluate the value of spirometrically controlled quantitative CT in the assessment of silicosis. Methods Forty six patients suffered from silicosis received lung spiral scans at 50% vital capacity (VC), and all of them were imaged with high resolution CT (HRCT) at carina and carina +/- 5 cm at 20% VC and 80% VC. Automatic evaluation software (Pulmo) was used to evaluate the pixel index(PI). PI was correlated with pulmonary function tests. Results High resolution CT (HRCT) was as sensitive as spiral CT for detection of silicosis. With the severity of silicosis worsened, the PI of <-910 HU (A interval) and > -610 HU (E interval) increased ( P <0.05 or P <0.01). API, EPI were correlated with FEV 1.0 and VC ( r =-0 801～0 690). Conclusion Spirometrically controlled quantitative CT is an effective and new method for the study of silicosis.