CT定量检测技术对COPD合并肺栓塞患者的诊断价值研究

Diagnostic value of CT quantitative detection technique in patients with COPD complicated with pulmonary embolism

目的研究CT定量检测技术对慢性阻塞性肺疾病(COPD)合并肺栓塞(PE)患者的诊断价值。方法选取2016年9月—2018年9月本院收治的65例COPD合并肺栓塞患者进行研究,按照随机数字表法分为研究组(32例)和对照组(33例)两组。对照组应用磁共振成像(MRI)检查,研究组应用CT定量检测技术检查。观察并比较患者肺气肿定量指标变化情况、残气量(RV)、肺总量(TLC)、第一秒用力呼气量(FEV1)、吸气一秒率(FEV1/VCMAX)、左肺E/L、右肺E/L、全肺E/L等肺功能指标情况以及两组对不同分型检出情况。结果研究组两肺体积、两肺PD15、两肺%LAA-950、右上肺%LAA-950、右中肺%LAA-950、右下肺%LAA-950、左上肺%LAA-950以及左下肺%LAA-950均明显高于对照组,两组比较差异显著(P<0.05)。两组患者的RV、TLC、FEV1、FEV1/VCMAX、左肺E/L、右肺E/L以及全肺E/L水平比较,均无统计学意义(P>0.05)。研究组A型、E型和M型诊断准确率均明显高于对照组,且研究组诊断总准确率达96.92%(63/65),对照组诊断总准确率为73.85%(48/65),两组比较差异显著(P<0.05)。栓塞区碘基值为(3.89±3.68),对照区碘基值为(7.97±3.36),两组比较差异显著(P<0.05)。结论 CT定量检测技术诊断COPD合并肺栓塞患者可较好的显示患者病变结构和肺部组织,更加利于早期确诊,同时能有效分辨栓子和肺栓塞程度,提高COPD合并肺栓塞的诊疗效果,降低临床死亡率。

Objective To study the diagnostic value of CT quantitative detection technique in patients with chronic obstructive pulmonary disease( COPD) complicated with pulmonary embolism( PE).Methods 65 patients with COPD and pulmonary embolism admitted to our hospital from September 2016 to September 2018 were enrolled in the study.They were divided into study group( n = 32) and control group( n = 33) according to random number table.The control group was examined by magnetic resonance imaging( MRI),and the study group was examined by CT quantitative detection technique. The quantitative indexes of emphysema,residual air volume( RV),total lung volume( TLC),forced expiratory volume in first second( FEV1),inspiratory one second rate( FEV1/VCMAX),left lung E/L,right lung E/L and whole lung E/L were observed and compared.Results The volume of two lungs,PD15 of two lungs,LAA-950 of two lungs,LAA-950 of right upper lung,LAA-950 of right middle lung,LAA-950 of right lower lung,LAA-950 of left upper lung,LAA-950 of left lower lung in the study group were significantly higher than those in the control group( P<0.05).There were no significant differences in RV,TLC,FEV1,FEV1/VCMAX,left lung E/L,right lung E/L and whole lung E/L between the two groups( P>0.05).The diagnostic accuracy of type A,E and M in the study group was significantly higher than that in the control group.The total diagnostic accuracy of the study group was 96.92%( 63/65),and it was 73.85%( 48/65) of the control group,with a significant difference between the two groups( P<0.05).The iodine value of the embolization area was( 3.89±3.68),and the iodine value of the control area was( 7.97±3.36).The difference between the two groups was statistically significant( P<0.05).Conclusions CT quantitative detection technology for the diagnosis of COPD patients with pulmonary embolism could show preferable disease structure and lung tissue,which is more conducive to early diagnosis,and could effectively distinguish the degree of embolism and pulmonary embolism,improve the diagnosis and treatment of patients with COPD combined with pulmonary embolism,and reduce the clinical mortality rate.