MDCT扫描精确评估气胸压缩比

目的 探讨MDCT精确评估气胸压缩比的价值。方法 回顾性分析92例气胸患者的胸部MDCT资料，测量气胸压缩肺容积和胸廓容积，计算气胸压缩比；在胸廓腋中线层面冠状面测量胸廓肺尖至膈顶的上下径（H），于肺上叶支气管下壁层面测量胸廓的左右径（W）和前后径（D），于相同层面测量气胸压缩肺的上下径（h）、左右径（w）和前后径（d），计算其比值（hwd/HWD），分别获得左右两肺气胸压缩比（Y）与hwd/HWD（X）的线性回归方程。结果 左肺的线性回归方程为Y=0.951-0.864X（r=-0.961，R²=0.922，P < 0.001）；右肺的线性回归方程为Y=0.936-0.808X（r=-0.966，R²=0.932，P < 0.001）。经上述回归方程计算的压缩比与CT测量压缩比差异均无统计学意义（P均> 0.05）。结论 在MDCT图像上对气胸压缩肺和胸廓各径线进行测量，并经过简单计算，即可精确评估气胸压缩比，为临床选择治疗方案提供参考。

MDCT in accurate evaluation of compression ratio of pneumothorax

Objective To explore the value of MDCT in accurate evaluation of compression ratio of pneumothorax. Methods MDCT data of 92 patients with pneumothorax were retrospectively analyzed. The volume of compressed and normal chest was measured with MDCT, and the compression ratio was calculated. The longitudinal diameter (H) of the chest was measured from thoracic apex to diaphragm in the coronal view of midaxillary line, and the chest width (W) and diameter (D) were measured at the level of the superior lobar bronchus. In the same way, the longitudinal diameter (h), width (w) and diameter (d) of the pneumothorax lung were obtained simultaneously, and the ratio of hwd/HWD was calculated. The linear regression equation was analyzed between the compression ratio (Y) and hwd/HWD (X) at both right and left lung, respectively. Results The correlation regression equation of left lung was Y=0.951-0.864X (r=-0.961, R²=0.922, P < 0.001), of right lung was Y=0.936-0.808X (r=-0.966, R²=0.932, P < 0.001). There was no significant difference of compression ratio obtained with correlation regression equations and MDCT (both P > 0.05). Conclusion The compression ratio of pneumothorax can be accurately evaluated with measuring the diameters of compressed lung and chest in MDCT, therefore providing references for clinical treatment.