基于计算机辅助测量COPD患者肺内血管体积的变化

Changes of intrapulmonary vascular volume for chronic obstructive pulmonary disease patients based on computer-assisted measurement

目的基于计算机辅助测量探索慢性阻塞性肺疾病(chronic obstructive lung disease, COPD)患者肺内血管体积(intrapulmonary vascular volume, IPVV)的变化。方法回顾性收集"数字肺"数据库中COPD男性患者167例,依据2017版慢性阻塞性肺疾病全球倡议(Global initiative for Chronic Obstructive Lung Disease, GOLD)的肺功能分级分为4组:GOLD 1级组、GOLD 2级组、GOLD 3级组、GOLD 4级组。同时收集体检健康的315例同年龄段非吸烟男性为正常对照组。使用肺血管测量工具自动提取肺内血管,获取全肺及各肺叶的IPVV。比较COPD组与正常对照组、GOLD各分组及正常对照组组间IPVV的差异。结果 GOLD 1级组、GOLD 2级组、GOLD 3级组、GOLD 4级组的全肺及各肺叶IPVV均大于正常对照组(P值均<0.05),但GOLD各分组间全肺及各肺叶IPVV无统计学差异(P值均>0.05)。结论肺内血管总体积是提示COPD的敏感指标,但不能区别GOLD各分级。

Objective To investigate the changes of intrapulmonary vascular volume(IPVV)of patients with chronic obstructive lung disease(COPD)based on computer-assisted measurement.Methods One-hundred and sixty-seven male COPD patients were collected retrospectively from the Digital Lung database,and divided into four subgroups:GOLD 1,GOLD 2,GOLD 3 and GOLD 4 according to the pulmonary function test of Global Initiative for Chronic Obstructive Lung Disease(GOLD).Chest CT images of 315 non-smoking normal males were collected from the Digital Lung database.The intrapulmonary vessels were extracted by an automated 3-dimentional protocol,IPVV of the whole lung and each lobe were obtained.The differences in IPVV between COPD and normal groups and among different COPD subgroups were compared.Results The IPVV of the whole lung and each lobe of COPD was significantly larger than that in normal control group(P<0.05).There was no significant difference in IPVV among GOLD 1,GOLD 2,GOLD 3 and GOLD 4 groups(P>0.05).Conclusion IPVV is a sensitive biomarker between normal cohorts and COPD patients,but cannot differentiate COPD stages.