黄晓旗,闫苗苗,王雷,赵凡惠,朱彦瑾,郭佑民.基于呼气相不同阈值分析慢性阻塞性肺疾病严重程度与肺功能的相关性[J].中国医学影像技术,2020,36(3):350~355
基于呼气相不同阈值分析慢性阻塞性肺疾病严重程度与肺功能的相关性
Analysis of relationship between the severity of chronic obstructive pulmonary disease and pulmonary function based on different threshold analysis of expiratory phase
投稿时间:2020-01-10  修订日期:2020-02-03
DOI:10.13929/j.issn.1003-3289.2020.03.006
中文关键词:  肺疾病,慢性阻塞性  肺气肿  体层摄影术,X线计算机
英文关键词:pulmonary disease,chronic obstructive  pulmonary emphysema  tomography,X-ray computed
基金项目:
作者单位E-mail
黄晓旗 延安大学附属医院影像科, 陕西 延安 716000  
闫苗苗 延安大学附属医院影像科, 陕西 延安 716000  
王雷 延安大学附属医院影像科, 陕西 延安 716000  
赵凡惠 延安大学附属医院影像科, 陕西 延安 716000  
朱彦瑾 延安大学附属医院影像科, 陕西 延安 716000  
郭佑民 西安交通大学第一附属医院医学影像科, 陕西 西安 710061 cjr.guoyoumin@vip.163.com 
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中文摘要:
      目的 分析深呼气末CT扫描肺气肿阈值-856 HU、-910 HU及-950 HU以下低衰减区占全肺体积百分比(LAA%-950、LAA%-910、LAA%-856)对慢性阻塞性肺疾病(COPD)严重程度的影响,探讨定量指标与肺功能的相关性。方法 收集104例COPD患者深呼气CT扫描数据及临床肺功能数据,根据慢性阻塞性肺疾病全球倡议(GOLD)指南将数据分为4组,将原始数据导入"数字肺"检测及分析平台,计算呼气相全肺平均肺密度(MLDex)、LAA%-950、LAA%-910及LAA%-856。肺功能指标包括用力肺活量(FVC)、用力肺活量占预计值百分比率(FVC%)、第1秒用力呼气容积率(FEV1%)、FEV1/FVC、一氧化碳弥散量实测值占预计值百分率(DLCO%)、单位肺体积一氧化碳弥散量(DLCO/VA)及残气量与肺总量比值(RV/TLC)。比较4组肺功能及CT定量参数的差异,分析CT定量参数与肺功能的相关性,以多元逐步回归分析观察LAA%-950、LAA%-910、LAA%-856与MLDex的关系。结果 4组间LAA%-950、LAA%-910、MLDex差异均有统计学意义(P均<0.01)。LAA%-910与FVC、FVC%、FEV1%、FEV1/FVC、DLCO%及DLCO/VA均呈负相关,与RV/TLV正相关。MLDex与LAA%-950、LAA%-910、LAA%-856均呈负相关。LAA%-950、LAA%-910与MLDex回归方程R2值0.917(P<0.01)。结论 呼气相CT扫描定量指标LAA%-910能准确评估COPD严重程度,并与肺功能具有良好相关性。
英文摘要:
      Objective To analyze the impact of the percentage of low attenuation area (LAA) in total lung volume (LAA%-950, LAA%-910, LAA%-856) with threshold lower than -856 HU, -910 HU and -950 HU on the severity of chronic obstructive pulmonary disease (COPD) in deep end expiratory CT scan, and to explore the correlations between quantitative indicators and pulmonary function. Methods CT images in deep expiratory and clinical lung function data of 104 COPD patients were collected. The patients were divided into 4 groups according to global initiative for chronic obstructive lung disease (GOLD) guidelines. Then data were imported into the "digital lung" detection and analysis platform, and the mean lung density in expiratory phase (MLDex) and LAA%-950, LAA%-910, LAA%-856 were calculated. Pulmonary function indicators, including forced vital capacity (FVC), forced vital capacity expressed as percent predicted (FVC%), forced expiratory volume in 1 second expressed as percent predicted (FEV1%), FEV1/FVC, carbon monoxide diffusion capacity expressed as percent predicted (DLCO%), carbon monoxide diffusion capacity corrected for alveolar volume (DLCO/VA) and residual volume to total lung capacity ratio (RV/TLC) were obtained. CT quantitative parameters and pulmonary function indexes were compared among 4 groups, and correlations of CT quantitative parameters and lung function were analyzed. Multiple stepwise regression analysis was performed to observe the relationships of LAA%-950, LAA%-910, LAA%-856 and MLDex. Results LAA%-950, LAA%-910 and MLDex were statistically significant among 4 groups (all P<0.01). LAA%-910 was negatively correlated with FVC, FVC%, FEV1%, FEV1/FVC, DLCO% and DLCO/VA, and positively correlated with RV/TLV. MLDex was negatively correlated with LAA%-950, LAA%-910 and Using LAA%-856. LAA%-950, LAA%-910 and MLDex could introduce a regression equation with R2=0.917 (P<0.01). Conclusion Expiratory CT quantitative index LAA%-910 be used to accurately assess the severity of COPD and has good correlation with pulmonary function.
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