肺高分辨率CT马赛克样灌注与小气道功能指数的相关分析

目的探讨肺小气道病变时高分辨率CT（HRCT）所示马赛克样灌注与小气道功能指标的相关性。方法选择HRCT上显示马赛克样灌注病例80例,由3位放射诊断医师对马赛克样灌注与小气道功能指标的相关性进行分析。结果马赛克样灌注与FEF 25%呈负相关（r=-0.48,P〈0.05）,与FEV1、FEF50%无相关性（r值分别为-0.27和-0.19,P〉0.05）。而空气潴留的程度与FEF25%、FEV1呈负相关（r值分别为-0.62和-0.41,P〈0.05）,与FEF 50%无相关性（r=-0.29,P〉0.05）。结论马赛克样灌注作为小气道病变的主要征象,其与FEF 25%具有良好的相关性,而空气潴留作为小气道阻塞的直接后果,其程度与FEV1、FEF 25%具显著相关性,即使肺功能检查结果正常时,也可以辅助诊断临床可疑的小气道阻塞。

The correlation between mosaic perfusion and small airway functional indexes in lungs showed by high resolution CT

Objective To investigate the correlation between mosaic perfusion and small airway functional indexes in lungs showed by high resolution CT(HRCT).Methods Eighty patients with mosaic perfusion undergoing HRCT were enrolled in the study.The correlation between mosaic perfusion and small airway functional indexes in lungs showed by HRCT was analyzed by three radiologists.Results The scores of mosaic perfusion were negatively correlated with forced expiratory flow at 25% of vital capacity(FEF25%)(P<0.05),however,which were not correlated significantly with forced expiratory volume in one second(FEV1) and forced expiratory flow at 50% of vital capacity(FEF50%)(P>0.05).Meanwhile the air-trapping was negatively correlated with forced expiratory volume in one second(FEV1)and forced expiratory flow at 25% of vital capacity(FEF25%)(P<0.01 or P<0.05),but it was not correlated with forced expiratory flow at 50% of vital capacity(FEF50%)(P>0.05).Conclusion Mosaic perfusion as a major feature of small airway diseases showed by HRCT is negatively correlated with forced expiratory flow at 25% of vital capacity(FEF25%)and forced expiratory volume in one second(FEV1),which may contribute to auxiliary diagnosis for patients with suspected small airway obstruction in clinic even if the results of pulmonary function test are normal.