64层螺旋CT肺容积成像在慢性阻塞性肺疾病中的诊断价值

目的 探讨64层螺旋CT肺容积扫描诊断慢性阻塞性肺疾病(COPD)的临床价值.资料与方法 COPD组87例,对照组29例,进行64层螺旋CT肺容积扫描和常规肺功能检查,两次检查时间间隔小于30d,研究CT肺容积参数与肺功能实验室指标之间的相关性,并采用ROC曲线分析CT肺容积参数对COPD诊断和分级的临床价值.结果 CT容积扫描获取的肺气肿容积比例与肺功能分级、RV(实际/预计％)、TLC(实际/预计％)、RV/TLC(％)、FEV1(实际/预测％)和FEV1/VC MAX(％)之间均存在显著相关(r分别为0.560,0.309,0.246,0.280,-0.522,-0.599,P均＜0.01):ROC曲线分析结果显示,全肺肺气肿容积比例、右肺肺气肿容积比例和左肺肺气肿容积比例诊断COPD的曲线下面积分别为0.863、0.822和0.917(P均＜0.01),差异有统计学意义.结论 CT测量的肺气肿容积与肺总容积之比和肺功能分级相关,对诊断COPD有预测意义.

Diagnostic Value of 64-slice Multi-detector Spiral CT Lung Volume Imaging in Chronic Obstructive Pulmonary Diseases

Purpose To explore the diagnostic value of lung volume screening with 64-slice multi-detector spiral CT in patients with chronic obstructive disease (COPD). Materials and Methods 87 cases of COPD and 29 cases of non-COPD controls chosen respectively, were performed with 64-slice multi-detector spiral CT and pulmonary function test in one month. The correlations between CT volume measure indexes and pulmonary function indexes were studied, and adopted ROC method to learn the clinical meaning of CT indexes screening COPD. Results The volume ratio of emphysema by CT measurements were well correlated the pulmonary functions indexes, including pulmonary functional grades(r=0.560, P<0.01), RV%(r=0.309, P<0.01), TLC% (r=0.246, P<0.01), RV/TLC% (r=0.280, P<0.01), FEV1%(r=-0.522, P<0.01) and FEV1/VC MAX% (r=-0.599, P<0.01), respectively. ROC analysis result showed that the area under curve of the volume ratio indexes of emphysema for both lungs, right lung and left lung in screening COPD were 0.863, 0.822 and 0.917, respectively. Conclusion The ratio of emphysema volume to lung volume measured by CT is correlated the pulmonary function test and can predict the early changes of COPD.