256层CT对轻度COPD患者肺容积及肺气肿的定量评价

发布时间：2018-04-13 23:37

本文选题：X-线计算机体层成像 + 慢性阻塞性肺疾病　；参考：《青海大学》2013年硕士论文

【摘要】：目的：应用256层CT对轻度COPD患者及肺功能检查（PFT）正常的对照组行CT影像学-PFT对照研究，从而探讨轻度COPD患者MSCT肺容积的变化，并对发生气肿的肺组织进行定量评估。方法：共收集轻度COPD患者14例、正常对照组15例，对29例受检者均行256层CT双相（最大吸气末、最大呼气末）扫描及PFT检查；然后应用Philips工作站（Extended Brilliance Workplace）自带的肺密度（lung density）测定软件对CT原始图像用阈值分割技术（阈值上限-500Hu、下限-1024Hu）将肺组织完全自动分离，并计算出MSCT-肺容积指标（Vin、LVin、RVin、Vex、LVex、RVex）、全肺和左右肺气肿肺组织的容积（cm~3）及气肿肺组织分别占全肺、左右肺的比例（即：像素指数PI）。将MSCT-肺容积指标与PFT容量参数（TLC、RV、VC、RV/TLC）、吸-呼气相设定不同阈值（-950Hu、-940Hu、-930Hu、-920Hu、-910Hu）时的像素指数（PI）与PFT通气参数（FEV1%、FEV1/FVC）进行Pearson积差相关分析；轻度COPD组与正常对照组间MSCT肺功能指标的比较用独立样本t检验。结果：1.所有受检者（29例）MSCT-肺容积指标Vin、Vex、Vin-Vex、Vex/Vin分别与PFT容量参数TLC、RV、VC、RV/TLC有较好相关性，，尤以Vin与TLC相关性最好，r=0.835，p0.05；2.与正常对照组比较，轻度COPD组MSCT-肺容积指标中最大呼气末容积（Vex、LVex、RVex）、容积比（Vex/Vin）增高，p0.05；而最大吸气末容积（Vin、LVin、RVin）、容积差（Vin-Vex）在两组间无统计学差异；3.吸-呼气相各像素指数中以呼气相PIex-910与PFT通气参数FEV1%、FEV1/FVC的相关性最好，r为-0.484、-0.590，p0.05；4.以MSCT肺气肿阈值为标准，发现14例轻度COPD患者均有肺气肿、15例PFT正常的对照组中12例有肺气肿，且轻度COPD组较正常对照组呼气相阈值为-910Hu的气肿肺容积（cm~3）及像素指数PIex-910均明显增高，p0.05。结论：1.MSCT-肺容积指标与PFT容量参数间存在着较好的相关性，故说明本研究应用256层CT对肺功能进一步评价的可行性；2.轻度COPD患者MSCT-肺容积指标中以最大呼气末容积（Vex、LVex、RVex）、容积比（Vex/Vin）的变化较有意义；3.界定PIex-910为Philips Brilliance256层iCT工作站（ExtendedBrilliance Workplace）肺密度（lung density）测定软件的肺气肿阈值，以此阈值为标准，可对轻度COPD患者气肿的肺组织进行定量评估、同时可以发现PFT检查尚正常的早期肺气肿患者。
[Abstract]:Objective: to investigate the changes of lung volume in patients with mild COPD and control group with normal pulmonary function by using 256-slice CT in order to investigate the changes of lung volume of MSCT in patients with mild COPD, and to evaluate quantitatively the lung tissue with emphysema.Methods: a total of 14 patients with mild COPD and 15 normal controls were examined with 256-slice CT biphasic scan (maximum inspiratory end, maximum expiratory end) and PFT.Then the lung density of extended Brilliance Workplace was measured by Philips workstation, and the lung tissue was separated automatically by threshold segmentation technique (upper threshold -500Hu-1024Hu) for the original CT images.The MSCT- lung volume index (VX) and the ratio of left and right lung tissues to the left and right lungs (I. e., pixel index PIN) were calculated, and the whole lung and left and right emphysema lung tissues were divided into the whole lung and the left and right lung tissues (I. e., pixel index PIN), and the volume of the whole lung, the volume of the left and right lung tissues of the whole lung and the left and right lung tissues were calculated.The pixel index (Pi) and the PFT ventilation parameter FEV1 / FVCC were analyzed by using MSCT- lung volume index and PFT volume parameter. The pixel index (Pi) and the PFT ventilation parameter FEV1 / FVCwere analyzed when different threshold values were set in the inhalation-expiratory phase: -950 Hu-940 Hu-930Hu-920Hu-910Hu.The lung function indexes of MSCT in mild COPD group and normal control group were compared with independent sample t test.The result is 1: 1.All the 29 patients with MSCT- lung volume index VexP / Vin had good correlation with PFT volumetric parameters (TLCV / TLC), especially Vin and TLC were best correlated with RV 0.835 (p0.05 / 2).Compared with the normal control group, the maximal end-expiratory volume (COPD) in the mild COPD group was significantly higher than that in the control group (P < 0.05), while there was no significant difference between the two groups in the maximal end-expiratory volume (VX) and the volume difference (Vin-Vexe).The correlation between expiratory PIex-910 and FEV1 / FEV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1According to the threshold value of MSCT emphysema, it was found that 12 of the 14 mild COPD patients had emphysema and 12 of the 15 normal PFT controls had emphysema.Compared with the normal control group, the emphysema lung volume and pixel index (PIex-910) of mild COPD group were significantly higher than that of normal control group (P 0.05).Conclusion 1. There is a good correlation between MSCT- pulmonary volume index and PFT volume parameter, which indicates the feasibility of further evaluation of lung function by 256-slice CT in this study.In patients with mild COPD, the maximal end-expiratory volume (MPV) and the volume ratio (VX / Vinn) were significant.PIex-910 was defined as the lung density threshold of Philips Brilliance256 layer iCT workstation (extended brilliant Workplace). The threshold value can be used as a criterion to evaluate the lung tissue of mild COPD patients with emphysema.Early emphysema patients with normal PFT examination can also be found.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.4;R563

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