肺CT定量指标在评估肺癌患者术前肺功能中的应用价值

Application Value of Lung CT Quantitative Indicators in Evaluating Preoperative Lung Function in Patients with Lung Cancer

目的:探讨肺电子计算机断层扫描(CT)定量指标在评估肺癌患者术前肺功能中的应用价值。方法:回顾性选取2021年1—10月昆明医科大学第三附属医院收治的280例肺癌患者,收集其术前CT检查图像做后处理分析得到CT定量指标,包括CT肺容积、平均肺密度及低衰减容积百分比(LAV%),并与同期肺功能检查(PFT)的主要结果进行相关性分析。结果:患者PFT指标最大肺容量(TLC)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及肺一氧化碳弥散量(DLCO)分别为(4.83±1.02)L、(2.46±0.58)L、(2.85±0.65)L、(8.90±2.11)mL/(min·mmHg),CT肺容积、平均肺密度和LAV%分别为(4111.17±1101.90)mL、(-821.46±40.90)HU及(18.94±9.40)%。CT肺容积与TLC、FVC及DLCO呈正相关(r=0.520、0.558、0.238,P<0.001、0.001、0.05),平均肺密度与TLC、FVC呈显著负相关(r=-0.278、-0.209,P<0.05),LAV%与FVC呈显著正相关(r=0.219、P<0.05)。结论:肺癌患者深吸气末CT肺容积、平均肺密度及LAV%与PFT参数之间具有良好的相关性,可用于辅助评估肺癌患者术前肺功能情况。

Objective:To explore the application value of lung computed tomography(CT)quantitative indicators in evaluating preoperative lung function in patients with lung cancer.Method:A total of 280 lung cancer patients admitted to the Third Affiliated Hospital of Kunming Medical University from January to October 2021 were selected retrospectively.The lung volume,average lung density HU values and low attenuation volume percentage(LAV%)were obtained respectively,and the correlation between each parameter and pulmonary function test(PFT)parameters were analyzed.Result:The total lung capacity(TLC),forced expiratory volume in one second(FEV1),forced vital capacity(FVC)and pulmonary carbon monoxide dispersion(DLCO)were respectively(4.83±1.02)L,(2.46±0.58)L,(2.85±0.65)L and(8.90±2.11)mL/(min·mmHg).The CT lung volume,average lung density and LAV%were respectively(4111.17±1101.90)mL,(-821.46±40.09)HU and(18.94±9.40)%.The CT lung volume was positively correlated with TLC,FVC and DLCO(r=0.520,0.558,0.238,P<0.001,0.001,0.05),average lung density was negatively correlated with TLC and FVC(r=-0.178,-0.209,P<0.05),LAV%was positively correlated with FVC(r=0.219,P<0.05).Conclusion:High correlation exists between inspiratory CT quantitative indicators and pulmonary function tests.It can be used to evaluate the preoperative lung function in patients with lung cancer.