| 关玉宝,曾庆思,陈桥丽,邓宇,伍筱梅,李时悦,郑劲平,钟南山.肺泡蛋白沉着症肺泡灌洗术前后定量CT应用评价[J].中国医学影像技术,2008,24(1):57~59 |
| 肺泡蛋白沉着症肺泡灌洗术前后定量CT应用评价 |
| Quantitative CT analysis before and after bronchoalveolar lavage in patients with pulmonary alveolar proteinosis |
| 投稿时间：2007-08-15 修订日期：2007-11-14 |
| DOI： |
| 中文关键词: 肺泡蛋白沉着症 支气管肺泡灌洗 定量 体层摄影术,X线计算机 |
| 英文关键词:Pulmonary alveolar proteinosis Bronchoalveolar lavage Quantitative analysis Tomography, X-ray computed |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨定量CT在肺泡蛋白沉着症(PAP)支气管肺泡灌洗术中的应用价值。方法 定量CT通过分析PAP患者最大吸气末肺容积、肺重量、肺含气体积、平均肺密度及平均含气体积结果,对10例PAP患者共14次(两肺13次,单肺1次)肺泡灌洗术CT资料进行分析。并结合常规CT(病灶范围、密度)、肺功能(检查9次)及血气分析检查(检查14次)结果进行对比分析。结果 PAP经支气管肺泡灌洗术后,定量CT检查显示肺重量从(1594±436) g减低至(1294±374) g(P=0.000),平均肺密度从(0.5269±0.12) g/ml减低至(0.4389±0.09) g/ml(P=0.006),平均肺充气体积从(1.0989±0.5031) ml/g增加至(1.4700±0.4548) ml/g(P=0.008),肺含气体积有一定程度增加(P=0.116),肺容积在灌洗后略增加(P=0.938);肺泡灌洗前后的肺容积与肺含气体积呈显著相关(绝对系数R2=0.94,P=0.000)。常规CT评价79%(11/14)CT检查结果改善。支气管肺泡灌洗术后有10次肺功能检查结果示DLCO％从45.85%±22.09%上升到54.64%±19.09%(P＝0.007)、DLCO/VA％从67.30%±22.62%上升到76.03%±18.60%(P＝0.03);FVC％、FEV1％、FEV1/FVC、PEF％也有不同程度改善,但无统计学差异(P>0.05)。14次血气分析显示从肺泡灌洗前的低氧血症[PaO2:(8.07±2.1) kpa]到肺泡灌洗后的明显好转[PaO2:(14.7±5.24) kpa](P=0.001)。结论 定量CT可为PAP疗效评估提供客观依据,肺泡灌洗术后以定量CT结果中的肺重量、平均肺密度及平均含气肺体积改善明显。常规CT评价对PAP疗效观察具有一定价值。通过肺泡灌洗术,大部分患者病情短期内得到显著改善。 |
| 英文摘要: |
| Objective To evaluate the clinical value of quantitative CT findings before and after bronchoalveolar lavage with pulmonary alveolar proteinosis. Methods Ten patients with pulmonary alveolar proteinosis had underwent the total 14 lavages (13 both-lung lavages and 1 single-lung lavage), were analyzed for quantitative CT findings before and after bronchoalveolar lavage. Quantitative CT analysis can obtain some information such as the total lung volume, airspace volume, lung weight, mean lung density and mean lung volume. Routine CT features can obtain some changes of lesions, including density, degree and extent. Pulmonary function test were examined in 8 patients (9 examinations). Blood gas analysis were examined in all patients.Results There were no changes in CT-measured total lung volume and airspace volume, but there were reductions from (1594±436) g to (1294±374) g in lung weight (P=0.000), mean lung density from (0.5269±0.12) g/ml to (0.4389±0.09) g/ml (P=0.006) and mean lung volume from (1.0989±0.5031) ml/g to (1.4700±0.4548) ml/g (P=0.008) following lavage. Total lung volume was correlated with the airspace volume before and after bronchoalveolar lavage (R2=0.94,P=0.000). 79% lavages on routine CT showed improvements in following lavage during short-term. 9 examinations showed improvements from 45.85% 22.09% to 54.64% 19.09% in percentage of predicted diffusion capacity (DLCO%) of the lung for carbon monoxide (P=0.007) and from 67.30%±22.62% to 76.03%±18.60% in percentage of predicted diffusion constant (DLCO/VA) (P=0.03), Although FVC％, FEV1％, FEV1/FVC, PEF％ have some improvements, the differences were not significant (P>0.05). Following lavage, the mean values of PaO2 improved from (8.07±2.10) kPa to (14.7±5.24) kPa (P=0.001). Conclusion Quantitative CT can objectively track the changes in lung weight, mean lung volume and mean lung density. Routine CT features has a preliminary evaluation from before to after lavage of PAP. 79% lavages showed improvements in following lavage during short-term. |
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