多层螺旋CT像素指数定量分析在新型冠状病毒肺炎评估中的应用价值研究

Research on the application value of MSCT pixel index quantitative analysis in COVID-19 assessment

目的探讨多层螺旋CT(MSCT)像素指数(PI)的定量分析在新型冠状病毒肺炎首次CT及病程评估中的临床应用价值。方法回顾性收集2020年1月22日至2020年3月1日惠州市中心人民医院确诊的48例新型冠状病毒肺炎患者胸部MSCT数据,使用肺功能Thoracic VCAR软件分割肺叶,测量PI<-700Hu、-700~-300Hu、>-300Hu值,分析首次CT检查肺叶PI特点及发病后不同时期阶段(第1周、第2周、第3周、第4周及以上)PI的变化规律。结果①PI<-700Hu、-700~-300Hu、>-300Hu肺叶组间比较差异具有统计学意义(P<0.05);②各肺叶组内两两比较:右肺中叶PI>-300Hu大于右肺上叶(P<0.05),双肺下叶PI-700~-300Hu、PI>-300Hu均大于双肺上叶、右肺中叶,双肺下叶PI<-700Hu均小于双肺上叶、右肺中叶(P<0.05),其余肺叶PI两两比较差异无统计学意义(P>0.05);③发病后第2周全肺PI-700~-300Hu、PI>-300Hu最高[11.41%(8.66%~19.24%)、2.47%(1.85%~4.36%)],PI<-700Hu最低[86.31%(74.70%~89.54%)]。结论基于MSCT的PI的定量分析可对COVID-19患者肺部渗出、实变进行量化评估,实现肺炎病灶从视觉半定量评估到定量测量转变,可结合常规CT用于COVID-19的病程动态评估。

Objective To explore the clinical value of quantitative analysis of multi-slice spiral CT(MSCT)pixel index(PI)in the first CT and disease course assessment of COVID-19.Methods The chest CT date of 48 patients diagnosed with COVID-19 in our hospital from January 22,2020 to March 1,2020 were collected.The Thoracic VCAR software was used for the pulmonary lobes segmentation and PI quantitative evaluation,PI values of pulmonary lope of<-700Hu,-700Hu—-300Hu,>-300Hu were measured.The characteristics of PI in the initial CT examination and the changes of PI among different stages(in 1st,2nd,3rd,4th and beyond weeks)were analyzed.Results①The difference of PI<-700Hu,PI-700Hu—-300Hu and PI>-300Hu between the lung lobe groups were found statistically significant(P>0.05).②Comparison between each lung lobe group:the PI>-300Hu of right middle lobe was higher than that of right upper lobe(P<0.05);PI-700Hu—-300Hu and PI>-300Hu of bilateral lower lobe were higher than those of bilateral upper lobe and lower right middle lobe,PI<-700Hu of bilateral lower lobe were lower than that of bilateral upper lobe and right middle lobe(P<0.05),and the rest of the lung lobe pairwise comparison were not statistically significant(P>0.05).③PI-700Hu—-300Hu and PI>-300Hu of whole lung were found highest in the second weeks after onset[11.41%(8.66%—19.24%)、2.47%(1.85%—4.36%)],while the PI-1024Hu—-300Hu of the whole lung was fount lowest[86.31%(74.70%—89.54%)].Conclusion The PI of MSCT CT can quantitatively analyze the pulmonary exudation and consolidation of COVID-19 patients,from visual assessment to accurate quantification.Combined with conventional CT,it can be used for clinical diagnosis and follow-up treatment evaluation of COVID-19 patients.