CT定量成像评估肺气肿的临床应用价值
发布时间：2019-06-20 04:43
【摘要】：目的 分析MSCT不同重建算法对于肺气肿CT定量测定结果的影响。对比肺密度定量测定与视觉评分结果两种方法对不同程度肺气肿的评估价值。 对象和方法 天津市海河医院2009年12月～2010年3月确诊COPD病例30例,行胸部MSCT扫描(男20例,年龄51-88岁,平均年龄70.5±8.94岁；女10例,年龄53～84岁,平均年龄71.1±7.46岁),原始数据分别经标准算法、肺算法及锐利算法重建组成标准算法组、肺算法组及锐利算法组,采用后处理技术对图像进行重组、分割并保留双肺部分,测定肺气肿指数(emphysema index, EI)、全肺平均肺衰减值(mean lung attenuation, MLA)及全肺容积(total lung volume, TLV),比较标准算法组、肺算法组及锐利算法组之间EI、MLA及TLV的差异性。采用相同扫描参数对一均匀水模行MSCT扫描10次,测量不同算法图像的平均密度、密度标准差、密度最大值和密度最小值的平均值。 天津市海河医院2010年3月～2010年10月确诊COPD病例30例,行胸部MSCT扫描。依照RV/TLC值分成轻度肺气肿组(A组)与中、重度肺气肿组(B组)。A组：RV/TLC40%且50%,其中男11例,女4例,年龄53-88岁,平均年龄67.27±11.11岁。B组：RV/TLC50%,其中男10例,女5例,年龄51-84岁,平均年龄68.73±10.17岁。对此30例肺气肿病人进行胸部MSCT扫描。由3位医师分别测量肺气肿指数(EI),计算视觉评分分数(VS),同时记录两种方法所需时间。对A、B两组不同医师间所得到结果的差异性与相关性进行比较。对A、B两组的EI与VS的相关性分别进行比较。对肺密度定量测量和视觉评分所需时间进行比较。 结果 EI在不同重建算法各组之间的差异均具有统计学意义(P0.05)。MLA标准算法组与锐利算法组之间的差异没有统计学意义(P0.05),其它各组之间差异均具有统计学意义(P0.05)。SDMLA各组之间差异均具有统计学意义(P0.05)。 TLV各组之间的差异均不存在统计学意义(P0.05)。水模测量结果发现锐利算法测量所得平均密度更加接近于水的密度,标准算法测量平均密度与锐利算法相近。标准算法、肺算法及锐利算法测量密度标准差及最大值、最小值呈递增趋势。 医师之间肺密度定量测量结果的一致性好于视觉评分结果的一致性(r=0.99-1.00VS r=0.35-0.97, P0.05)。视觉评分结果医师之间的一致性,B组好于A组(r=0.73～0.97VS r=0.35-0.77, P0.05),肺密度定量测量结果的一致性A、B两组之间差异极小(r=0.99～1.00VS r=0.98-0.99, P0.05)。B组病人EI与VS的相关性好于A组病人EI与VS的相关性(r=0.725VS r=0.317, P0.05).肺密度定量测量平均时间为7.88±0.80min,视觉评分平均时间为4.42±0.40min,二者之间差异具有统计学意义(P0.05)。 结论 ①肺气肿CT定量测定中不同原始数据重建算法的选择能够影响EI值、MLA值,而对TLV值的影响不大。 ②标准重建算法更适用于MSCT肺气肿CT定量测定。 ③肺密度定量测量与视觉评分结果之间具有相关性。肺气肿定量测量较视觉评分相比医师之间评估结果的一致性更高。 ④肺气肿视觉评分结果的一致性较差,特别是轻度肺气肿时。对轻度肺气肿病人进行评估与随访时应采用定量测量方法。
[Abstract]:Purpose Analysis of the effect of different reconstruction algorithms of MSCT on the quantitative determination of emphysema CT The evaluation of different degree of emphysema by comparing the quantitative and visual scores of the lung density with the results of visual scoring value. Yes image and method,30 cases of COPD were diagnosed from December of 2009 to March 2010, and 30 cases of COPD were diagnosed by MSCT (male in 20, age 51-88 years, mean age 70.5-8.94 years), female 10 cases (age 53-84 years, mean age 71.1 and 7.46 years), and raw data The standard algorithm, the lung algorithm and the sharp algorithm are used to reconstruct the standard algorithm group, the lung algorithm group and the sharp algorithm group, and the post-processing technique is adopted to carry out the recombination, segmentation and retention of the double-lung part of the image, the emphysema index (EI) and the mean lung average lung attenuation value (mean lung attunu) are measured. The EI, MLA and TL between the standard algorithm group, the lung algorithm group and the sharp algorithm group were compared by the total lung volume (TLV), the total lung volume (TLV), the comparison standard algorithm group, the lung algorithm group and the sharp algorithm group. The difference of V is that the average density, the density standard deviation, the density maximum and the density of the image of a uniform water model are measured by the same scanning parameters for 10 times, and the average density, the density standard deviation, the density maximum and the density of the images of different algorithms are measured. Mean value of the value.30 cases of COPD diagnosed by Tianjin Haihe Hospital from March 2010 to October 2010, and chest and chest Partial MSCT scan. divided into mild emphysema group (group A) and moderate and severe lung in accordance with the RV/ TLC values Group A: RV/ TLC40% and 50%, male 11, female 4, age 53-88, mean age 67.27 11.11-year-old. Group B: RV/ TLC50%, male 10, female 5, age 51-84, mean age 68.73 The chest was 10.17 years old. In this 30 cases of emphysema, the patient was treated with a chest Part MSCT scans. The emphysema index (EI) was measured by 3 physicians, and the visual score (VS) was calculated, and both were recorded. The time required for the method. The difference of the results obtained between the two groups in group A and group B was the same as that of the two groups. The correlation is compared. The correlation between the EI and VS in both groups A and B Comparison of the sex of the lung, the quantitative measurement of the lung density and the visual score On-demand Results The difference between the group of the MLA standard algorithm group and the sharp algorithm group was not unified. The difference between the other groups was statistically significant (P0.05). The difference between the TLVs and the TLVs does not exist. The measurement results of the water model show that the average density obtained by the sharp algorithm is closer to the density of water, and the standard algorithm measures The average density is similar to the sharp algorithm. The standard algorithm, the lung algorithm and the sharp algorithm measure the density standard deviation and the most The minimum value is increasing. The consistency of the quantitative measurement of the lung density between the physicians is better than the consistency of the visual scoring results (r = 0.99-1.00 VS r = 0.3 5-0.97, P0.05). The consistency between the visual score and the physician, group B was better in group A (r = 0.73-0.97 VS r = 0.35-0.77, P0.05), and the difference between the two groups was very small (r = 0.99-1.00 VS r = 0.9). The correlation between EI and VS in group B was better than that in group A (r = 0.725 VS r). The mean time of the quantitative measurement of lung density was 7.88-0.80 min and the mean time of visual scoring was 4.42-0.40 min. a series of Conclusion The selection of different raw data reconstruction algorithms in the quantitative determination of emphysema in emphysema can influence the EI value. And the value of the TLV is not affected by the value of the TLV. The algorithm is more suitable for the quantitative determination of MSCT emphysema. The relationship between the quantitative measurement of lung density and the results of visual scoring. Quantitative measurement of emphysema A higher degree of consistency in the results of the assessment between the physicians as compared to the visual score. Poor consistency in the results of the swelling visual scoring, especially in mild emphysema.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.4
本文编号：2502941
[Abstract]:Purpose Analysis of the effect of different reconstruction algorithms of MSCT on the quantitative determination of emphysema CT The evaluation of different degree of emphysema by comparing the quantitative and visual scores of the lung density with the results of visual scoring value. Yes image and method,30 cases of COPD were diagnosed from December of 2009 to March 2010, and 30 cases of COPD were diagnosed by MSCT (male in 20, age 51-88 years, mean age 70.5-8.94 years), female 10 cases (age 53-84 years, mean age 71.1 and 7.46 years), and raw data The standard algorithm, the lung algorithm and the sharp algorithm are used to reconstruct the standard algorithm group, the lung algorithm group and the sharp algorithm group, and the post-processing technique is adopted to carry out the recombination, segmentation and retention of the double-lung part of the image, the emphysema index (EI) and the mean lung average lung attenuation value (mean lung attunu) are measured. The EI, MLA and TL between the standard algorithm group, the lung algorithm group and the sharp algorithm group were compared by the total lung volume (TLV), the total lung volume (TLV), the comparison standard algorithm group, the lung algorithm group and the sharp algorithm group. The difference of V is that the average density, the density standard deviation, the density maximum and the density of the image of a uniform water model are measured by the same scanning parameters for 10 times, and the average density, the density standard deviation, the density maximum and the density of the images of different algorithms are measured. Mean value of the value.30 cases of COPD diagnosed by Tianjin Haihe Hospital from March 2010 to October 2010, and chest and chest Partial MSCT scan. divided into mild emphysema group (group A) and moderate and severe lung in accordance with the RV/ TLC values Group A: RV/ TLC40% and 50%, male 11, female 4, age 53-88, mean age 67.27 11.11-year-old. Group B: RV/ TLC50%, male 10, female 5, age 51-84, mean age 68.73 The chest was 10.17 years old. In this 30 cases of emphysema, the patient was treated with a chest Part MSCT scans. The emphysema index (EI) was measured by 3 physicians, and the visual score (VS) was calculated, and both were recorded. The time required for the method. The difference of the results obtained between the two groups in group A and group B was the same as that of the two groups. The correlation is compared. The correlation between the EI and VS in both groups A and B Comparison of the sex of the lung, the quantitative measurement of the lung density and the visual score On-demand Results The difference between the group of the MLA standard algorithm group and the sharp algorithm group was not unified. The difference between the other groups was statistically significant (P0.05). The difference between the TLVs and the TLVs does not exist. The measurement results of the water model show that the average density obtained by the sharp algorithm is closer to the density of water, and the standard algorithm measures The average density is similar to the sharp algorithm. The standard algorithm, the lung algorithm and the sharp algorithm measure the density standard deviation and the most The minimum value is increasing. The consistency of the quantitative measurement of the lung density between the physicians is better than the consistency of the visual scoring results (r = 0.99-1.00 VS r = 0.3 5-0.97, P0.05). The consistency between the visual score and the physician, group B was better in group A (r = 0.73-0.97 VS r = 0.35-0.77, P0.05), and the difference between the two groups was very small (r = 0.99-1.00 VS r = 0.9). The correlation between EI and VS in group B was better than that in group A (r = 0.725 VS r). The mean time of the quantitative measurement of lung density was 7.88-0.80 min and the mean time of visual scoring was 4.42-0.40 min. a series of Conclusion The selection of different raw data reconstruction algorithms in the quantitative determination of emphysema in emphysema can influence the EI value. And the value of the TLV is not affected by the value of the TLV. The algorithm is more suitable for the quantitative determination of MSCT emphysema. The relationship between the quantitative measurement of lung density and the results of visual scoring. Quantitative measurement of emphysema A higher degree of consistency in the results of the assessment between the physicians as compared to the visual score. Poor consistency in the results of the swelling visual scoring, especially in mild emphysema.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.4
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