慢性阻塞性肺疾病气道病变的64层MSCT与肺功能的相关性研究

目的：探讨64层螺旋CT对慢性阻塞性肺疾病（COPD）气道病变的影像学改变与常规肺功能检查（PFT）的相关性。方法：选取COPD患者（男29例,女10例）及正常对照组（男34例,女11例）进行高分辨率CT（HRCT）和常规肺功能检查。CT扫描分别于深吸气末和深呼气末进行。观察COPD小气道异常的主要HRCT征象：马赛克灌注、呼气末空气潴留征、小叶中心型肺气肿、支气管扩张、支气管壁增厚。分析气道异常与PFT检查参数值的相关性。结果：①HRCT所见COPD与对照组的气道异常的发生率有显著性差异（P〈0.05）;②COPD患者HRCT显示小气道异常与PFT检查结果有相关性,主要表现为：支气管壁增厚、马赛克灌注、呼气末空气潴留征与残气容积/肺总量（RV/TLC）和最大呼气流率（MEF）相关（P值均〈0.05）,支气管扩张与一秒用力呼气容积（FEV1）、残气容积/肺总量（RV/TLC）相关（P〈0.05）,小叶中心型肺气肿与残气容积相关（P〈0.05）。结论：64层螺旋CT获取HRCT可用于COPD气道病变的诊断,HRCT显示COPD的气道异常征象与PFT指标相关。

Correlation between 64-slice multi-detector spiral CT appearances and pulmonary functional test in airways abnormality of chronic obstructive pulmonary diseases

Objective：To explore the appearances of airway lesions of chronic obstructive pulmonary disease（COPD） on high resolution computed tomography（HRCT） by correlating with conventional pulmonary function test（PFT）.Methods：Both HRCT scans and conventional PFTs were performed on 39 cases of COPD（29 men,10 women） and 45 cases of normal controls（34 men,11 women）.All the cases underwent HRCT scans at both full inspiration and end expiration,for the evaluation and scoring of small airways lesions,such as mosaic perfusion,end-expiration air trapping,centrilobular emphysema,bronchial dilation and wall thickening.The CT scans were scored by two observers.The CT signs were then correlated with PFT results.Results：① There was significant difference in the occurrence of small airway lesions between COPD and controls;② Correlation existed between small airway lesions and PFT parameters in COPD.Thickening of bronchial wall correlated well with RV/TLC and MEF（P〈0.05）;Bronchiactasis correlated well with FEV1 and RV/TLC（P〈0.05）;mosaic perfusion and end expiration air trapping correlated well with RV/TLC and MEF（P〈0.05）;centrolobular emphysema correlated well with RV（P〈0.05）.Conclusion：HRCT can be used for the diagnosis of small airway lesions.Small airway lesions on HRCT correlate well with conventional PFT in COPD.