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CT肺气肿容积及小阴影密集度与尘肺肺功能相关性的研究

赵琪琪 冯莉 刘玉全 王梅芳

赵琪琪, 冯莉, 刘玉全, 等. CT肺气肿容积及小阴影密集度与尘肺肺功能相关性的研究[J]. CT理论与应用研究, 2023, 32(1): 1-9. DOI: 10.15953/j.ctta.2021.049
引用本文: 赵琪琪, 冯莉, 刘玉全, 等. CT肺气肿容积及小阴影密集度与尘肺肺功能相关性的研究[J]. CT理论与应用研究, 2023, 32(1): 1-9. DOI: 10.15953/j.ctta.2021.049
ZHAO Q Q, FENG L, LIU Y Q, et al. Correlation between Emphysema Volume and Small Shadow Density on Computed Tomography and the Lung Function in Pneumoconiosis[J]. CT Theory and Applications, 2023, 32(1): 1-9. DOI: 10.15953/j.ctta.2021.049. (in Chinese)
Citation: ZHAO Q Q, FENG L, LIU Y Q, et al. Correlation between Emphysema Volume and Small Shadow Density on Computed Tomography and the Lung Function in Pneumoconiosis[J]. CT Theory and Applications, 2023, 32(1): 1-9. DOI: 10.15953/j.ctta.2021.049. (in Chinese)

CT肺气肿容积及小阴影密集度与尘肺肺功能相关性的研究

doi: 10.15953/j.ctta.2021.049
详细信息
    作者简介:

    赵琪琪:女,锦州医科大学全科医学专业型研究生,主要从事尘肺影像学与肺功能相关研究,E-mail:874933120@qq.com

    刘玉全:男,十堰市太和医院主任医师、研究生导师,主要擅长呼吸系统疾病的诊断和治,E-mail:lyqliuyuquan123456@163.com

    通讯作者:

    男,十堰市太和医院主任医师,研究生导师,主要擅长呼吸系统疾病的诊断和治,E-mail:lyqliuyuquan123456@163.com

  • 中图分类号: R  814

Correlation between Emphysema Volume and Small Shadow Density on Computed Tomography and the Lung Function in Pneumoconiosis

  • 摘要: 目的:比较尘肺患者肺气肿程度及肺部小阴影对肺功能的影响。方法:选择2015年至2020年间十堰市太和医院收治的明确诊断尘肺且合并肺气肿的患者96名,进行胸部CT检查及肺功能测定;采用64排螺旋CT(GE Optima CT 680)进行三维容量测量系统定量分析全肺、左右肺、各肺上中下肺野低衰减区容积百分比(LAV%),并根据全肺LAV% 将其分为A组:LAV%<15%,B组:LAV%15%~30%,C组:LAV%>30% 三组,分析肺气肿分布特点及与肺功能的相关性;将胸片评定小阴影密集度的标准应用于CT中得出CT图像的全肺、左右肺、上中下肺野小阴影密集度(SSD),并分析与肺功能的相关性。结果:全肺SSD与FEV1、TLC、PEF、MEF75%、MEF25% 呈负相关,与RV/TLC呈正相关;全肺、左肺、右肺、及上中下肺野LAV% 与FEV1、FEV1%、DLCO、PEF、MEF75%、MEF50%、MEF25% 呈负相关,与RV、RV/TLC% 呈正相关;当LAV%>30% 时,即C组LAV% 与肺功能FEV1、FEV1%、DLCO、RV/TLC、PEF、MEF75%、MEF50%、MEF25% 间的相关性较A组和B组好;肺部小阴影密集度与肺通气功能、容积参数有一定相关性,但与弥散功能相关性较弱。结论:尘肺患者肺气肿程度及小阴影密集度与肺功能均有一定相关性,但肺气肿较小阴影密集度与肺功能相关性更好,且能在一定程度上评估尘肺患者肺损伤程度,值得临床推广应用。

     

  • 图  1  分别为A、B、C组部分尘肺患者肺部CT冠状位图像及轴位图像,冠状位图像由气管纵向水平上用等分点的水平线将左右肺各分为上、中、下3个肺野,蓝色区域为肺气肿低衰减区三维图像

    Figure  1.  Coronal and axial CT images of some patients with pneumoconiosis in groups A, B, and C. The left and right lungs were divided into upper, middle, and lower lung fields from the vertical level of the trachea using equidistant horizontal lines; blue areas present emphysema as three-dimensional images of low-attenuation areas

    表  1  各肺野LAV% 数据表

    Table  1.   LAV% data for each lung field

    数据范围右肺 左肺
    右肺上野中野下野左肺上野中野下野
    -1024~-950/%24.03024.12022.42825.237 23.08023.05319.10526.269
    -950~3071/%75.97075.88177.57274.76376.92076.94780.89573.731
    Total/L4.3000.9841.4561.8603.3840.8431.1281.413
    下载: 导出CSV

    表  2  A、B、C组组间总体SSD间差异性分析

    Table  2.   Comparison of the total SSD among groups A, B, and C

    项目SSD
    ABBCAC
    M(Q25,Q75)2(1,3)2(2,3)2(2,3)2(1,3)2(1,3)2(1,3)
    Z-0.454-0.373-0.537
    P 0.650 0.767 0.591
     注:M(Q25,Q75)为A、B、C三组总体小阴影密集度中位数及四分位数,组间对比不符合正态分布采用非参数检验得到P>0.05,
       三组总体小阴影密集度对比差异无统计学意义。
    下载: 导出CSV

    表  3  A组各肺野SSD、LAV% 与肺功能指标的相关性分析

    Table  3.   Analysis of correlation between SSD and LAV% of the lung field and lung function indexes in group A

    A组右上右中右下左上左中左下
    SSDLAV%SSDLAV%SSDLAV%SSDLAV%SSDLAV%SSDLAV%
     FEV1-0.0990.019-0.157-0.093-0.330*-0.073-0.2280.132-0.317*-0.203-0.1720.065
     FEV1%0.159-0.0680.0370.060-0.124-0.159-0.0370.005-0.085-0.337*-0.0760.082
     FVC-0.2580.020-0.374*-0.034-0.388*-0.047-0.2960.084-0.501**-0.231-0.385*0.123
     DLCO0.035-0.022-0.007-0.0550.0530.119-0.077-0.0910.011-0.233-0.0790.268
     RV-0.0790.192-0.124-0.0480.0270.070-0.0360.194-0.0820.082-0.019-0.060
     TLC-0.0040.256-0.030-0.030-0.1520.080-0.0100.386*-0.0820.262-0.0020.008
     RV/TLC0.1400.0890.058-0.1990.187-0.1620.176-0.0250.1640.1790.171-0.148
     PEF0.020-0.034-0.144-0.145-0.267-0.083-0.0910.134-0.250-0.253-0.1220.057
     MEF75%-0.055-0.059-0.055-0.127-0.262-0.250-0.0610.048-0.225-0.322*-0.1060.097
     MEF50%-0.057-0.018-0.057-0.032-0.249-0.189-0.1100.048-0.213-0.310*-0.1650.114
     MEF25%-0.1160.040-0.1160.218-0.2510.107-0.0950.121-0.227-0.253-0.2860.106
     注:*为P<0.05,**为P<0.01。
    下载: 导出CSV

    表  4  B组各肺野SSD、LAV% 与肺功能指标的相关性分析

    Table  4.   Analysis of correlation between SSD and LAV% of the lung field and lung function indexes in group B

    B组右上右中右下左上左中左下
    SSDLAV%SSDLAV%SSDLAV%SSDLAV%SSDLAV%SSDLAV%
     FEV1-0.0530.247-0.149-0.036-0.096-0.314-0.1230.102-0.009-0.211-0.080-0.521*
     FEV1%-0.0240.314-0.1900.025-0.075-0.304-0.0740.128-0.104-0.133-0.147-0.615*
     FVC-0.179-0.078-0.263-0.177-0.079-0.133-0.209-0.038-0.009-0.111-0.161-0.407*
     DLCO0.0620.157-0.365-0.269-0.1540.0200.041-0.0250.239-0.227-0.288-0.224
     RV-0.170-0.095-0.024-0.1120.0480.035-0.227-0.025-0.069-0.1380.0090.009
     TLC-0.1490.155-0.056-0.020-0.268-0.270-0.2190.1960.147-0.038-0.041-0.113
     RV/TLC0.170-0.0920.187-0.1790.1910.450*0.118-0.1480.0390.0510.1200.321
     PEF0.0850.215-0.153-0.015-0.235-0.152-0.0440.0600.028-0.121-0.140-0.280
     MEF75%0.0720.266-0.0550.084-0.002-0.155-0.0330.0600.021-0.1330.013-0.478*
     MEF50%0.0480.201-0.067-0.1120.015-0.243-0.0180.037-0.004-0.259-0.043-0.533*
     MEF25%-0.1520.199-0.2140.024-0.162-0.180-0.2380.012-0.176-0.201-0.174-0.479*
     注:*为P<0.05。
    下载: 导出CSV

    表  5  C组各肺野SSD、LAV% 与肺功能指标的相关性分析

    Table  5.   Analysis of correlation between SSD and LAV% of the lung field and lung function indexes in group C

    C组右上右中右下左上左中左下
    SSDLAV%SSDLAV%SSDLAV%SSDLAV%SSDLAV%SSDLAV%
     FEV10.324-0.453*0.242-0.435*-0.126-0.555*0.030-0.575*0.053-0.554*0.149-0.519*
     FEV1%0.302-0.513*0.209-0.420*-0.007-0.532*0.076-0.552*0.068-0.581*0.205-0.389*
     FVC-0.1380.010-0.181-0.086-0.284-0.2050.036-0.137-0.042-0.156-0.102-0.291
     DLCO0.338-0.2820.511*-0.506*0.420*-0.503*0.395-0.3260.492*-0.523*0.648*-0.410*
     RV-0.3580.065-0.3150.2210.2600.347-0.1910.268-0.1990.490*-0.563*0.325
     TLC-0.033-0.2850.0430.085-0.362-0.110-0.248-0.414*-0.136-0.203-0.136-0.233
     RV/TLC0.1500.0420.0480.130-0.1340.2110.2420.1510.1970.2990.1150.332
     PEF0.250-0.535*0.069-0.324-0.211-0.469*-0.111-0.575*-0.069-0.476*0.003-0.530*
     MEF75%0.161-0.498*-0.036-0.297-0.266-0.423*-0.199-0.529*-0.178-0.395-0.053-0.496*
     MEF50%0.136-0.376-0.077-0.229-0.338-0.329-0.201-0.367-0.153-0.286-0.139-0.431*
     MEF25%0.040-0.312-0.031-0.202-0.377-0.298-0.221-0.306-0.114-0.239-0.141-0.404*
     注:*为P<0.05。
    下载: 导出CSV
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  • 收稿日期:  2021-11-23
  • 录用日期:  2022-03-28
  • 网络出版日期:  2022-04-13

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