基于HDCT定量技术的慢性阻塞性肺疾病早期诊断的研究

Study on Early Diagnosis of Chronic Obstructive Pulmonary Disease Based on HDCT Quantitative Technology

目的通过胸部CT定量分析COPD患者及PRISm患者支气管、肺血管的部分定量参数,观察其对COPD早期诊断的临床应用价值。方法回顾性分析2019年9月—2021年3月在复旦大学附属华东医院行双气相胸部CT平扫病例73例,并分析其CT定量参数与PFT检查结果的相关性及各组病例之间差异性。结果FEV1%pre分别与WL容积比、RL容积比、RUL容积比、RML容积比、LUL容积比、WL段以下支气管/肺容积、RL段以下支气管/肺容积、RUL段以下支气管/肺容积、RML段以下支气管/肺容积等参数成正相关(r分别为:0.280、0.284、0.300、0.282、0.236、0.261、0.324、0.302、0.289,P<0.05)。FEV1/FVC分别与WL容积比、RL容积比、LL容积比、RUL容积比、RML容积比、LUL容积比、LLL容积比、WL段以下支气管/肺容积、RL段以下支气管/肺容积、RUL段以下支气管/肺容积、RML段以下支气管/肺容积、RLL段以下支气管/肺容积等参数成正相关(r分别为:0.372、0.393、0.264、0.292、0.309、0.367、0.245、0.236、0.306、0.407、0.311、0.296、0.333,P<0.05)。DLco分别与距胸膜6mm血管数量(WL)、距胸膜6mm血管数量(RL)、距胸膜6mm血管数量(LL)、距胸膜6mm血管数量(RML)、距胸膜6mm血管数量(RLL)成正相关(r分别为:0.296、0.281、0.301、0.351,P<0.05)。结论CT定量参数作为联合诊断指标可以为COPD早期诊断提供临床价值,血管数量的定量分析可以反映患者弥散功能。

Objective To quantitatively analyze some quantitative parameters of bronchial and pulmonary vessels in COPD patients and PRISM patients by chest CT,and to observe its clinical application value in early diagnosis of COPD.Methods 73cases of chest CT plain scan in our hospital from September2019to March2021were analyzed retrospectively,and the correlation between CT quantitative parameters and PFT results and the differences among each group of cases were analyzed.Results FEV1%pre was positively correlated with WL volume ratio,RL volume ratio,RUL volume ratio,RML volume ratio,LUL volume ratio,WL lobar bronchus/lung volume,RL lobar bronchus/lung volume,RUL lobar bronchus/lung volume,RML lobar bronchus/lung volume and so on(r:0.280,0.284,0.300,0.282,0.236,0.261,0.324,0.302,0.289,respectively,P<0.05).FEV1/FVC was positively correlated with WL volume ratio,RL volume ratio,LL volume ratio,RUL volume ratio,RML volume ratio,LUL volume ratio,LLL volume ratio,WL lobar bronchus/lung volume,RL lobar bronchus/lung volume,RUL lobar bronchus/lung volume,RUL lobar bronchus/lung volume,RLL lobar bronchus/lung volume,RLL lobar bronchus/lung volume And other parameters were positively correlated(r:0.372,0.393,0.264,0.292,0.309,0.367,0.245,0.236,0.306,0.407,0.311,0.296,0.333,respectively,P<0.05).DLCO was positively correlated with the number of blood vessels6mm away from the pleura(WL),6mm away from the pleura(RL),6mm away from the pleura(LL),6mm away from the pleura(RML),and6mm away from the pleura(RLL)(r=0.296,0.281,0.301,0.351,P<0.05,respectively).Conclusion CT quantitative parameters can provide clinical value for early diagnosis of COPD as a combined diagnostic index,and quantitative analysis of blood vessel number can reflect the diffusion function of patients.