定量CT对肺泡蛋白沉着症肺泡灌洗术前后的应用分析

发布时间：2018-04-04 09:07

本文选题：肺泡蛋白沉着症支气管肺泡灌洗术体层摄影术　切入点：X线计算机定量　出处：《临床放射学杂志》2014年03期

【摘要】：目的探讨并评估定量CT在肺泡蛋白沉着症(PAP)支气管肺泡灌洗术中的应用价值。方法通过定量CT分析PAP患者最大吸气末肺气体总容积、肺总重量、肺平均CT值、肺平均密度值结果及像素指数直方图,对15例PAP患者共18次行肺泡灌洗术的CT资料进行定量分析,并结合肺功能检查(共14次)资料进行对比。结果 PAP经支气管肺泡灌洗术后,定量CT检查显示肺气体总容积有一定程度的增加(P=0.128),肺总重量从(1698±409)g减至(1307±381)g(P=0.001),平均CT值从(-761.7±36.1)HU减至(-895.7±26.3)HU(P=0.015),肺平均密度值从(0.5867±0.15)g/cm3减低至(0.4453±0.07)g/cm3(P=0.007)。像素指数直方图直观显示灌洗后像素指数范围较灌洗前减小。支气管灌洗术后有14次肺功能检查结果显示DLCO%从(50.15±19.18)%上升至(56.37±17.89)%(P=0.018)、DLCO/VA%从(70.01±19.18)%上升至(78.17±15.36)%(P=0.045);用力肺活量(FVC)、第一秒用力呼气量占预计值的百分比(FEV1%)、FEV1/FVC亦有不同程度的改善,但均无统计学意义(P0.05)。结论定量CT可对PAP灌洗术的疗效评估提供比较客观、精确的依据,为临床评估PAP肺泡灌洗术的疗效提供新的评价方法。
[Abstract]:Objective to investigate and evaluate the quantitative CT in pulmonary alveolar proteinosis (PAP) application value in the bronchoalveolar lavage. Methods by quantitative CT analysis of PAP with the maximum inspiratory lung gas volume, total lung weight, lung mean CT values, results and pixel index histogram mean lung density values for the quantitative analysis of 15 cases a total of 18 PAP patients underwent bronchoalveolar lavage CT data, combined with pulmonary function test (total 14 times) data were compared. Results PAP by bronchoalveolar lavage, quantitative CT showed that the lung gas volume increased to a certain extent (P=0.128), total lung weight from (1698 + 409) g. To (1307 + 381) G (P=0.001), the average value from CT (-761.7 + 36.1) reduced to HU (-895.7 + 26.3) HU (P=0.015), the mean lung density values from (0.5867 + 0.15) reduced to g/cm3 (0.4453 + 0.07) g/cm3 (P=0.007). The pixel index histogram display lavage after the pixel index range compared with Wash before decrease. Bronchoalveolar lavage after 14 pulmonary function tests showed that DLCO% from (50.15 + 19.18)% to (56.37 + 17.89)% (P=0.018), from DLCO/VA% (70.01 + 19.18)% to (78.17 + 15.36)% (P=0.045); forced vital capacity (FVC), the first second using force expiratory volume percentage of predicted value (FEV1%), FEV1/FVC also have different degrees of improvement, but had no statistical significance (P0.05). Conclusion CT can assess the efficacy of quantitative PAP lavage provides more objective and accurate basis for clinical efficacy evaluation, PAP lavage provided a new evaluation method.

【作者单位】：广东医学院附属厚街医院放射科;广州医学院第一附属医院放射科;
【基金】：广州医学院基金研究课题(编号:A2011013)
【分类号】：R563.9

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