基于肺密度阈值分割法下结缔组织相关肺间质病CT肺容积评估的临床研究

The practice of clinical application of CT lung volume assessment for CTD-ILD based on threshold segmentation method of lung density

目的:基于肺密度阈值分割法进行CT肺容积检测,探讨其在结缔组织相关性肺间质病(CTD-ILD)诊断中的应用价值。方法:选取在医院诊治的73例结缔组织病患者临床资料,将高分辨CT(HRCT)检查影像纳入对照组,联合肺容积测量数据纳入观察组。全肺组织容积(WL)采集密度阈值为(-1000^-200)HU,正常肺组织容积(NL)采集密度阈值为(-950^-700)HU,肺间质病容积(ILDV)采集阈值为(-700^-500)HU。采用x2检验和Spearman相关分析对两组指标数据进行对比。结果:观察组的诊断准确率为95.89%,高于对照组的93.10%,其差异有统计学意义(x^2=5.056,P<0.05);对照组的肺纤维化评分与GAP等级评分显著相关(r=0.54,P<0.05);观察组的全肺容积、正常肺组织容积、间质纤维化病变组织容积百分比与GAP等级评分呈显著相关水平(r=-0.67,r=0.78,r=0.69;P<0.05),间质纤维化病变组织容积、正常肺组织容积百分比与GAP等级评分呈高度相关水平(r=0.86,r=-0.83;P<0.05)。结论:联合肺容积技术能有效提高CTD-ILD患者的影像诊断率,肺容积参数能较好地预测临床疾病严重程度,具有较高的临床应用价值。

Objective:To implement computed tomography(CT)lung volume detection based on threshold segmentation method of lung density,and explore its application value in connective tissue disease-associated interstitial lung disease(CTD-ILD).Methods:The clinical data of 73 patients with connective tissue disease admitted to the radiology department of Shan-xi province tuberculosis hospital were selected and were divide into control group had the imaging data of high resolution CT(HRCT)and observation group had the measured data of combined lung volume.The threshold value of collected density of whole lung tissue volume(WL)was(-1000^-200)HU,and that of normal lung tissue volume(NL)was(-950^-700)HU,and the collected threshold value of interstitial lung disease volume(ILDV)was(-700^-500)HU.Chi-square test and Spearman correlation analysis were used to compare the data of the indicators of two groups.Results:The diagnostic accuracy of observation group(95.89%)was significantly higher than that of control group(93.10%)(x^2=5.056,P<0.05).The lung fibrosis score was significantly correlation with GAP rating score in control group(r=0.54,P<0.05).In observation group,the whole lung volume,normal lung tissue volume and percentage of interstitial fibrosis lesion tissue volume were significantly correlation with GAP rating score(r=-0.67,r=0.78,r=0.69,P<0.05),and interstitial fibrosis lesion tissue volume and the percentage of normal lung tissue volume were significantly higher correlation with GAP grade score(r=0.86,r=-0.83,P<0.05),respectively.Conclusion:The combined lung volume technique can effectively improve the diagnostic accuracy of imaging of CTDILD patients.And lung volume parameters can better predict the severity of clinical disease and they have higher clinical application value.