多层螺旋计算机断层扫描在尘肺病病例肺动脉主干直径测量中应用

Application of multi-slice computed tomography in measuring the diameter of main pulmonary artery of patients with pneumoconiosis

目的探讨多层螺旋计算机断层扫描(MSCT)多平面重建技术在尘肺病病例肺动脉主干直径测量中的可行性。方法采用随机抽样方法,对334例尘肺病病例在MSCT多平面重建图像上测量肺动脉主干与升主动脉直径,比较不同工种、接尘时间、尘肺病期别、合并肺气肿以及融合块形成组间病例的肺动脉主干直径,分析其肺动脉高压(PAH)发生的分布情况及差异。结果尘肺叁期组病例肺动脉主干直径分别高于尘肺壹期组和尘肺贰期组病例(P<0.05);合并肺气肿和伴发融合块形成病例的肺动脉主干直径分别高于无合并肺气肿、无融合块形成者(P<0.01)。334例尘肺病病例中,发生PAH者76例(发生率为22.8%)。尘肺叁期组病例PAH发生率分别高于尘肺壹期组和尘肺贰期组病例(P<0.05)。合并肺气肿和伴发融合块形成病例的PAH发生率分别高于无合并肺气肿、无融合块形成者(29.4%vs 17.1%,29.9%vs 15.0%,P<0.01)。不同工种和接尘时间组病例PAH发生率分别比较,差异均无统计学意义(P>0.05)。结论 MSCT多平面重建技术有助于更精确地测量肺动脉主干直径。影响肺动脉主干直径的因素包括尘肺病期别、合并肺气肿及伴发融合块形成,而且该3种因素对PAH的发生有影响。

Objective To investigate the feasibility of multi-planar reconstruction（ MPR） technique with multi-slice computed tomography（ MSCT） in measuring the diameters of main pulmonary arteries in patients with pneumoconiosis.Methods With simple random sampling method,334 pneumoconiosis patients examined by MSCT were selected as study objects. The diameters of the main pulmonary arteries and the ascending aortas were measured using MPR images captured from MSCT. The diameters of the main pulmonary arteries were compared among groups of patients with different types of work,duration of dust exposure,stages of pneumoconiosis,combined pulmonary emphysema and conglomerate masses.The distribution features and differences of pulmonary artery hypertension（ PAH） in pneumoconiosis patients were also analyzed. Results The diameters of the main pulmonary artery in group of pneumoconiosis stage Ⅲ were higher than those in groups of pneumoconiosis stage Ⅰ and Ⅱ respectively（ P〈0. 05）; the diameters of the main pulmonary artery in groups with emphysema and conglomerate masses were higher than those in groups without emphysema and conglomerate masses respectively（ P〈0. 01）. The incidence of PAH was 22. 8%（ 76 /334）. The PAH incidence in group of pneumoconiosis stage Ⅲ were higher than those in groups of pneumoconiosis stage Ⅰ and Ⅱ respectively（ P〈0. 05）. The incidence of PAH in groups with emphysema and conglomerate masses were higher than groups without emphysema and conglomerate masses respectively（ 29. 4% vs 17. 1%,29. 9% vs 15. 0%,P〈0. 01）. The incidence of PAH in groups of different types of work and duration of dust exposure showed no statistical significant difference（ P〉0. 05）. Conclusion MPR technique with MSCT can accurately measure the diameter of the main pulmonary artery. The influencing factors of diameter of pulmonary include the stage of pneumoconiosis,combined emphysema and conglomerate masses formation,which could also affect the incidence of PAH.