双源CT双能量肺灌注成像对COPD患者自动定量评估及其与肺功能、肺气肿指数相关性研究

发布时间：2018-06-17 02:19

本文选题：慢性阻塞性肺疾病 + 双能量　；参考：《扬州大学》2017年硕士论文

【摘要】：第一部分双源CT双能量肺灌注成像自动定量评估对COPD患者与正常者对照性研究目的探讨双源CT双能量肺灌注成像自动定量评估对COPD患者与正常者之间是否具有差异性。材料与方法18例未见异常者为对照组;62例COPD患者:结合2015版慢性阻塞性肺疾病全球倡议(GOLD)按严重程度分组,将COPD患者分为四组(GOLD Ⅰ组15例,GOLD Ⅱ组 18 例,GOLD Ⅲ组 17 例,GOLD Ⅳ组 12 例)。使用 Siemens Syngo.via工作站肺双能量软件进行自动定量分析全肺及局域肺灌注相对增强值。应用SPSS20.0统计分析软件处理数据。计量资料用均数±标准差(x±s)表示。组间比较采用方差分析,均数间两两比较采用LSD法(最小显著差异法)。P≤0.05为差异有统计学意义。结果对照组局域肺灌注相对增强值与COPD各组差异均有统计学意义(P0.05)。对照组全肺灌注相对增强值与COPD各组差异均有统计学意义(P0.05)。其中GOLD Ⅰ组全肺相对增强值与GOLD Ⅲ组、GOLD Ⅳ组间差异有统计学意义;GOLD Ⅱ组全肺相对增强值与GOLD Ⅲ组、GOLD Ⅳ组间差异有统计学意义;GOLD Ⅲ组全肺相对增强值与GOLD Ⅳ组间差异有统计学意义(P0.05)。GOLD Ⅰ组全肺相对增强值与GOLD Ⅱ组间差异无统计学意义(P0.05)。结论双源CT双能量肺灌注成像的全肺及局域肺灌注相对增强值对COPD患者与正常者之间有明显差异,双源CT双能量肺灌注定量评估可用来区分COPD患者和正常者,可以评价COPD肺实质破坏严重程度。第二部分双源CT双能量肺灌注成像对COPD患者自动定量评估及其与肺功能、肺气肿指数相关性研究目的探讨双源CT双能量肺灌注成像自动定量分析肺灌注相对增强值与肺功能检查参数、肺气肿指数的关系,评估COPD全肺及区域肺功能。材料与方法对于62例COPD患者进行双源CT双能量肺灌注增强扫描及肺功能检查。通过Siemens Syngo.via工作站肺双能量软件进行自动定量分析全肺及区域肺灌注相对增强值及肺气肿指数。使用肺功能检测仪获得肺功能参数,测定的主要指标有用力肺活量(FVC)、用力呼气第1秒量(FEV1)、第1秒用力呼气量占用力肺活量之比(FEV1/FVC),用力呼气第1秒量的实测值与预测值的百分比(FEV1/Pred)。应用SPSS20.0统计分析软件处理数据。Pearson相关分析肺功能参数与全肺灌注相对增强值、肺气肿指数的相关性,以及区域肺相对增强值与区域肺气肿指数的相关性,定义P0.05差异有统计学意义,计量资料用均数±标准差(x±s)表示。结果全肺相对增强值与FEV1(r=0.480,P=0.025)、FEV1%预计值(r=0.601,P=0.001)、FVC(r=0.526,P=0.011)、FEV1/FVC(r=0.539,P=0.010)均呈正相关。全肺肺气肿指数与 FEV1(r=-0.574,P=0.004)、FEV1/Pred(r=-0.605,P=0.002)、FVC(r=-0.572,P=0.004)、FEV1/FVC(r=-0.474,P=0.022)均呈负相关。全肺相对增强值与全肺肺气肿指数呈负相关(r=-0.605,P=0.000)。各区域肺相对增强值与对应的区域肺气肿指数中度负相关(P0.05)。结论 COPD患者应用双源CT双能量肺灌注自动定量肺相对增强值与肺气肿指数、肺功能参数具有相关性,可用来评估肺实质破坏及气道阻塞程度;区域肺相对增强值与区域肺气肿指数中度相关,能实现肺实质破坏区域和区域低灌注之间相匹配;COPD患者应用双源CT双能量肺灌注自动定量软件可快速对全肺、区域肺灌注及肺气肿进行独立定量评估。
[Abstract]:The first part of the dual source CT dual energy lung perfusion imaging automatic quantitative assessment of COPD patients and normal subjects to study the purpose of the dual source CT dual energy lung perfusion imaging automatic quantitative assessment of whether there is difference between COPD patients and normal people. Material and methods 18 cases of no abnormality in the control group; 62 cases of COPD patients: combined with 2015 slow plate slow The global initiative for obstructive pulmonary disease (GOLD) was divided into four groups (15 cases in group GOLD I, 18 in group GOLD II, 18 in group GOLD II, 17 in group GOLD III, 12 in group GOLD IV). The relative enhancement of lung and local pulmonary perfusion was quantified using Siemens Syngo.via workstation. Analysis software processing data. The measurement data were expressed with mean standard deviation (x + s). The difference between the groups was compared with the variance analysis. The difference between the average number of 22 and the.P < 0.05 was statistically significant (P0.05) in the control group (P0.05). The results of the comparison between the control group and the control group were statistically significant (P0.05). The relative enhancement of lung perfusion and COPD groups were statistically significant (P0.05). The relative enhancement value of whole lung in group GOLD I was statistically significant between group GOLD III and group GOLD IV; the relative enhancement value of whole lung in group GOLD II and group GOLD III, GOLD IV group was statistically significant; the relative enhancement value of whole lung in GOLD III group and GOLD IV group in group GOLD III group The difference was statistically significant (P0.05), there was no significant difference between the whole lung relative enhancement value and the GOLD II group in the.GOLD I group (P0.05). Conclusion the relative enhancement value of the whole lung and local lung perfusion of dual source CT dual energy lung perfusion imaging has obvious difference between the COPD patients and the normal ones. The dual source CT dual energy lung perfusion quantitative assessment can be used to distinguish COPD. Patients and normal people can evaluate the severity of COPD lung parenchyma damage. Second the automatic quantitative evaluation of COPD patients with dual source CT dual energy perfusion imaging and the correlation of pulmonary function and emphysema index with two source CT dual energy lung perfusion imaging for automatic quantitative analysis of pulmonary perfusion relative enhancement and pulmonary function examination parameters, The relationship between the emphysema index and the pulmonary function of COPD whole lung and region. Materials and methods were used to perform dual source CT dual energy lung perfusion enhanced scan and lung function examination in 62 patients with COPD. The pulmonary and pulmonary perfusion relative enhancement value and emphysema index of the whole lung and region were quantitatively analyzed by the lung dual energy software of Siemens Syngo.via workstation. Pulmonary function testing instrument obtained the parameters of lung function. The main indexes were forced vital capacity (FVC), forced expiration 1 second (FEV1), 1 second forced expiratory volume (FEV1/FVC), the measured value of forced expiration 1 second and the percentage of predicted values (FEV1/Pred). SPSS20.0 statistical analysis software was used to deal with the data.Pearson correlation. The relative enhancement of pulmonary function parameters and whole lung perfusion, the correlation of emphysema index, the correlation between regional pulmonary emphysema and regional pulmonary emphysema index, the difference between the P0.05 and the measured data was statistically significant, and the measurement data were expressed with mean standard deviation (x + s). Results all lung phase contrast enhancement and FEV1 (r=0.480, P=0.025), FEV1% prediction value (r=0) .601, P=0.001), FVC (r=0.526, P=0.011), FEV1/FVC (r=0.539, P=0.010) are all positive correlation. All lung emphysema index and FEV1 (r=-0.574, P=0.004) are negatively correlated. All lung relative enhancement values are negatively correlated with the whole lung emphysema index. The relative enhancement value of the domain lung was negatively correlated with the corresponding regional emphysema index (P0.05). Conclusion the application of dual source CT dual energy lung perfusion in COPD patients with the pulmonary emphysema index and the pulmonary function parameters is related to the assessment of pulmonary parenchyma damage and the degree of airway obstruction; regional pulmonary relative enhancement and regional lung qi. The moderate correlation of the swelling index can match the area of lung parenchyma destruction and regional low perfusion, and COPD patients can quickly evaluate the whole lung, regional pulmonary perfusion and emphysema by the dual source CT dual energy lung perfusion automatic quantitative software.
【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.9;R816.41

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