CAJ | 학술논문

目的评价低剂量MSCT定量成像技术对吸烟患者肺功能检测的可行性.方法选择临床诊断为慢性阻塞性肺疾病(COPD)患者146例,其中吸烟者109例(74.6％),不吸烟者37例(25.3％),通过常规肺功能检查及低剂量MSCT检查,在最大吸气末及最大呼气末屏气扫描,所有数据通过肺计算机辅助检查系统软件进行分割计算,使用Pearson方法分析吸烟患者与非吸烟患者的低剂量MSCT肺功能参数的差异性及吸烟患者低剂量MSCT肺功能参数与常规肺功能参数的相关性.结果吸烟患者深吸气末肺容积(Vin)为(5125±862) ml,平均肺衰减值为(-902±26)HU,单位体积密度为(0.0984±0.0260) g/cm3,肺气肿体积为(2890±1370) ml；深呼气末肺容积(Vex)为(2756±1027) ml,平均肺衰减值为(-811±62)HU,单位体积密度为(0.1878±0.0631) g/cm3,肺气肿体积为(685±104) ml.非吸烟患者Vin为(3734±759) ml,平均肺衰减值为(-876±40)HU,单位体积密度为(0.1244±0.0401)g/cm3,肺气肿体积为(1503±1217)ml；Vex为(1770±679) ml,平均肺衰减值为(- 765±56)HU,单位体积密度为(0.2360±0.0563) g/cm3,肺气肿体积为(156±45)ml.吸烟者与非吸烟者低剂量MSCT肺功能检查各指标差异均有统计学意义(P＜0.01).吸烟患者低剂量扫描MSCT肺功能参数与常规肺功能参数相关性显示:Vin与肺总量(TLC)有相关性(r=0.58,P＜0.01),Vex与残气量(RV)有相关性(r=0.59,P＜0.01),Vex/Vin与RV/TLC有相关性(r=0.60,P＜0.01),以促发阈值为- 950 HU时的吸气末像素指数(PI-950in)与第1秒用力呼气量预测值(FEV1％ pre)及FEV1/用力肺活量预测值(FvC％)均有相关性(r值分别为-0.53、-0.62,p值均＜0.01)；呼气末(PI-950ex)与FEV1％ pre及FEV1/FVC％均有相关性(r值分别为-0.71、-0.77,P值均＜0.01).结论低剂量MSCT肺功能检查能很好地评估吸烟患者的肺功能情况,可作为临床评估吸烟患者肺功能的一种新的检查方法.
목적 평개저제량MSCT정량성상기술대흡연환자폐공능검측적가행성.방법 선택림상진단위만성조새성폐질병(COPD)환자146례,기중흡연자109례(74.6％),불흡연자37례(25.3％),통과상규폐공능검사급저제량MSCT검사,재최대흡기말급최대호기말병기소묘,소유수거통과폐계산궤보조검사계통연건진행분할계산,사용Pearson방법분석흡연환자여비흡연환자적저제량MSCT폐공능삼수적차이성급흡연환자저제량MSCT폐공능삼수여상규폐공능삼수적상관성.결과 흡연환자심흡기말폐용적(Vin)위(5125±862) ml,평균폐쇠감치위(-902±26)HU,단위체적밀도위(0.0984±0.0260) g/cm3,폐기종체적위(2890±1370) ml；심호기말폐용적(Vex)위(2756±1027) ml,평균폐쇠감치위(-811±62)HU,단위체적밀도위(0.1878±0.0631) g/cm3,폐기종체적위(685±104) ml.비흡연환자Vin위(3734±759) ml,평균폐쇠감치위(-876±40)HU,단위체적밀도위(0.1244±0.0401)g/cm3,폐기종체적위(1503±1217)ml；Vex위(1770±679) ml,평균폐쇠감치위(- 765±56)HU,단위체적밀도위(0.2360±0.0563) g/cm3,폐기종체적위(156±45)ml.흡연자여비흡연자저제량MSCT폐공능검사각지표차이균유통계학의의(P＜0.01).흡연환자저제량소묘MSCT폐공능삼수여상규폐공능삼수상관성현시:Vin여폐총량(TLC)유상관성(r=0.58,P＜0.01),Vex여잔기량(RV)유상관성(r=0.59,P＜0.01),Vex/Vin여RV/TLC유상관성(r=0.60,P＜0.01),이촉발역치위- 950 HU시적흡기말상소지수(PI-950in)여제1초용력호기량예측치(FEV1％ pre)급FEV1/용력폐활량예측치(FvC％)균유상관성(r치분별위-0.53、-0.62,p치균＜0.01)；호기말(PI-950ex)여FEV1％ pre급FEV1/FVC％균유상관성(r치분별위-0.71、-0.77,P치균＜0.01).결론 저제량MSCT폐공능검사능흔호지평고흡연환자적폐공능정황,가작위림상평고흡연환자폐공능적일충신적검사방법.
Objective To evaluate the clinical feasibility of low dose MSCT for quantitative assessment of pulmonary function in smokers.Methods One hundred and forty-six patients with chronic objective pulmonary disease ( COPD ) including 109 smokers ( 74.6％ ) and 37 non-smokers ( 25.3％ )underwent pulmonary function test and low-dose MSCT scan.All data were analyzed using computer-aided lung anlysis software.Pulmonary function parameters from low-dose MSCT were compared between smokers and non-smokers and also compared with pulmonary function test in non-smokers ( Pearson test).Results In smokers,the average volume at full inspiratory phase (Vin) was (5125 ± 862 ) ml,mean lung attenuation was ( - 902 ± 26 ) HU,mean lung density was (0.0984 ± 0.0260 ) g/cm3,emphysema volume was (2890 ±1370) ml.The average volume at full expiratory phase (Vex) was (2756 ±1027) ml,mean lung attenuation was ( -811 ±62) HU,mean lung density was (0.1878 ±0.0631 ) g/cm3,emphysema volume was (685 ±104) ml.In non-smokers,the average Vin was (3734 ± 759) ml,mean lung attenuation was ( -876 ±40) HU,mean lung density was (0.1244 ±0.0401 )g/cm3,emphysema volume was ( 1503 ± 1217) ml.The average Vex was ( 1770 ± 679 ) ml,mean lung attenuation was ( - 765 ± 56 ) HU,mean lung density was (0.2360 ± 0.0563 ) g/cm3,emphysema volume was ( 156 ± 45 ) ml.There were significant differences between smokers and non-smokers (P ＜0.01 ).The Vex/Vin was correlated with residual volume/total lung capacity ( RV/TLC,r =0.60,P＜0.01 ),and Vin was correlated with TLC ( r =0.58,P ＜ 0.01 ),Vex with RV ( r =0.59,P＜0.01 ).Pixel index ( PI ) -950in was correlated with FEV 1％ pre and FEV1/FVC％ ( r =- 0.53,- 0.62,respective,P ＜ 0.01 ),Pl-950ex was correlated with FEV1 ％ pre and FEV1/FVC％ ( r =-0.71,-0.77,respective,P＜0.0l).Conclusion Low-dose MSCT can be a potential imaging tool for quantitative pulmonary function assessment in smokes.