CT支气管定量分析技术在实变型肺挫伤合并急性呼吸窘迫综合征中的应用

目的 探讨CT支气管定量分析技术在实变型肺挫伤合并急性呼吸窘迫综合征（ARDS）中的临床应用价值。方法 回顾性分析34例实变型肺挫伤合并ARDS患者的资料，应用FACT-Digital Lung^TM软件分割CT图像，计算肺挫伤病灶体积占双肺容积的百分比，测量临床治疗前后肺挫伤病灶处2~4级支气管内腔横截面积、管壁横截面积、最大壁厚、平均壁厚、管腔最大密度、管腔平均密度、管腔内直径、管腔外直径、管腔内周长及管腔外周长。并进行统计学分析。结果 34例共56处肺挫伤病灶，治疗前肺挫伤病灶处2~4级支气管内腔横截面积、管壁横截面积、管腔内直径、管腔外直径、管腔内周长及管腔外周长均小于治疗后（P均<0.05），最大壁厚及平均壁厚均大于治疗后（P均<0.05），治疗前后管腔最大及平均密度差异均无统计学意义（P均>0.05）。肺挫伤病灶体积占双肺容积的百分比与胸部创伤严重程度评分呈正相关（r=0.71，P<0.01）。结论 CT支气管定量分析技术可直观显示实变型肺挫伤合并ARDS患者支气管形态学变化。

Application of CT quantitative analysis of bronchi in consolidation-type pulmonary contusion combined with acute respiratory distress syndrome

Objective To explore the clinical value of CT quantitative analysis of bronchi technique in consolidation-type pulmonary contusion combined with acute respiratory distress syndrome (ARDS).Methods Data of 34 patients with consolidation-type pulmonary contusion combined with ARDS were retrospectively analyzed. CT images were segmented using FACT-Digital Lung^TM software. The percentage of pulmonary contusion lesions'' volume accounted for bilateral pulmonary volume was calculated. The bronchial lumen cross-sectional area, wall cross-sectional area, maximum wall thickness, average wall thickness, maximum lumen density, average lumen density, intraluminal diameter, outer diameter, inner circumference and outer circumference of grade 2 to 4 bronchi in pulmonary contusion lesions were measured before and after clinical treatment. Then statistical analysis was performed.Results There were 56 pulmonary contusion lesions in 34 patients. The bronchial lumen cross-sectional area, wall cross-sectional area, intraluminal and outer diameters, inner and outer circumferences of grade 2 to 4 bronchi in pulmonary contusion lesions before treatment were smaller than those after treatment (all P<0.05), while the maximum and average wall thickness were larger than those after treatment (all P<0.05). There was no significant difference of the maximum and average lumen densities before and after treatment (both P>0.05). The percentage of pulmonary contusion lesions'' volume accounted for bilateral pulmonary volume positively correlated with thoracic trauma severity score (r=0.71, P<0.01).Conclusion CT quantitative analysis of bronchi technique can visually show the morphological changes of bronchi in patients with consolidation-type pulmonary contusion combined with ARDS.