本文選題：X-線計(jì)算機(jī)體層成像 + 慢性阻塞性肺疾病　； 參考：《青海大學(xué)》2013年碩士論文

【摘要】：目的：應(yīng)用256層CT對(duì)輕度COPD患者及肺功能檢查（PFT）正常的對(duì)照組行CT影像學(xué)-PFT對(duì)照研究，從而探討輕度COPD患者M(jìn)SCT肺容積的變化，并對(duì)發(fā)生氣腫的肺組織進(jìn)行定量評(píng)估。 方法：共收集輕度COPD患者14例、正常對(duì)照組15例，對(duì)29例受檢者均行256層CT雙相（最大吸氣末、最大呼氣末）掃描及PFT檢查；然后應(yīng)用Philips工作站（Extended Brilliance Workplace）自帶的肺密度（lung density）測定軟件對(duì)CT原始圖像用閾值分割技術(shù)（閾值上限-500Hu、下限-1024Hu）將肺組織完全自動(dòng)分離，并計(jì)算出MSCT-肺容積指標(biāo)（Vin、LVin、RVin、Vex、LVex、RVex）、全肺和左右肺氣腫肺組織的容積（cm~3）及氣腫肺組織分別占全肺、左右肺的比例（即：像素指數(shù)PI）。將MSCT-肺容積指標(biāo)與PFT容量參數(shù)（TLC、RV、VC、RV/TLC）、吸-呼氣相設(shè)定不同閾值（-950Hu、-940Hu、-930Hu、-920Hu、-910Hu）時(shí)的像素指數(shù)（PI）與PFT通氣參數(shù)（FEV1%、FEV1/FVC）進(jìn)行Pearson積差相關(guān)分析；輕度COPD組與正常對(duì)照組間MSCT肺功能指標(biāo)的比較用獨(dú)立樣本t檢驗(yàn)。 結(jié)果：1.所有受檢者（29例）MSCT-肺容積指標(biāo)Vin、Vex、Vin-Vex、Vex/Vin分別與PFT容量參數(shù)TLC、RV、VC、RV/TLC有較好相關(guān)性，，尤以Vin與TLC相關(guān)性最好，r=0.835，p0.05；2.與正常對(duì)照組比較，輕度COPD組MSCT-肺容積指標(biāo)中最大呼氣末容積（Vex、LVex、RVex）、容積比（Vex/Vin）增高，p0.05；而最大吸氣末容積（Vin、LVin、RVin）、容積差（Vin-Vex）在兩組間無統(tǒng)計(jì)學(xué)差異；3.吸-呼氣相各像素指數(shù)中以呼氣相PIex-910與PFT通氣參數(shù)FEV1%、FEV1/FVC的相關(guān)性最好，r為-0.484、-0.590，p0.05；4.以MSCT肺氣腫閾值為標(biāo)準(zhǔn)，發(fā)現(xiàn)14例輕度COPD患者均有肺氣腫、15例PFT正常的對(duì)照組中12例有肺氣腫，且輕度COPD組較正常對(duì)照組呼氣相閾值為-910Hu的氣腫肺容積（cm~3）及像素指數(shù)PIex-910均明顯增高，p0.05。 結(jié)論：1.MSCT-肺容積指標(biāo)與PFT容量參數(shù)間存在著較好的相關(guān)性，故說明本研究應(yīng)用256層CT對(duì)肺功能進(jìn)一步評(píng)價(jià)的可行性；2.輕度COPD患者M(jìn)SCT-肺容積指標(biāo)中以最大呼氣末容積（Vex、LVex、RVex）、容積比（Vex/Vin）的變化較有意義；3.界定PIex-910為Philips Brilliance256層iCT工作站（ExtendedBrilliance Workplace）肺密度（lung density）測定軟件的肺氣腫閾值，以此閾值為標(biāo)準(zhǔn)，可對(duì)輕度COPD患者氣腫的肺組織進(jìn)行定量評(píng)估、同時(shí)可以發(fā)現(xiàn)PFT檢查尚正常的早期肺氣腫患者。
[Abstract]:Objective: to investigate the changes of lung volume in patients with mild COPD and control group with normal pulmonary function by using 256-slice CT in order to investigate the changes of lung volume of MSCT in patients with mild COPD, and to evaluate quantitatively the lung tissue with emphysema.Methods: a total of 14 patients with mild COPD and 15 normal controls were examined with 256-slice CT biphasic scan (maximum inspiratory end, maximum expiratory end) and PFT.Then the lung density of extended Brilliance Workplace was measured by Philips workstation, and the lung tissue was separated automatically by threshold segmentation technique (upper threshold -500Hu-1024Hu) for the original CT images.The MSCT- lung volume index (VX) and the ratio of left and right lung tissues to the left and right lungs (I. e., pixel index PIN) were calculated, and the whole lung and left and right emphysema lung tissues were divided into the whole lung and the left and right lung tissues (I. e., pixel index PIN), and the volume of the whole lung, the volume of the left and right lung tissues of the whole lung and the left and right lung tissues were calculated.The pixel index (Pi) and the PFT ventilation parameter FEV1 / FVCC were analyzed by using MSCT- lung volume index and PFT volume parameter. The pixel index (Pi) and the PFT ventilation parameter FEV1 / FVCwere analyzed when different threshold values were set in the inhalation-expiratory phase: -950 Hu-940 Hu-930Hu-920Hu-910Hu.The lung function indexes of MSCT in mild COPD group and normal control group were compared with independent sample t test.The result is 1: 1.All the 29 patients with MSCT- lung volume index VexP / Vin had good correlation with PFT volumetric parameters (TLCV / TLC), especially Vin and TLC were best correlated with RV 0.835 (p0.05 / 2).Compared with the normal control group, the maximal end-expiratory volume (COPD) in the mild COPD group was significantly higher than that in the control group (P < 0.05), while there was no significant difference between the two groups in the maximal end-expiratory volume (VX) and the volume difference (Vin-Vexe).The correlation between expiratory PIex-910 and FEV1 / FEV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FEV1 / FV1 / FEV1 / FV1 / FEV1 / FV1According to the threshold value of MSCT emphysema, it was found that 12 of the 14 mild COPD patients had emphysema and 12 of the 15 normal PFT controls had emphysema.Compared with the normal control group, the emphysema lung volume and pixel index (PIex-910) of mild COPD group were significantly higher than that of normal control group (P 0.05).Conclusion 1. There is a good correlation between MSCT- pulmonary volume index and PFT volume parameter, which indicates the feasibility of further evaluation of lung function by 256-slice CT in this study.In patients with mild COPD, the maximal end-expiratory volume (MPV) and the volume ratio (VX / Vinn) were significant.PIex-910 was defined as the lung density threshold of Philips Brilliance256 layer iCT workstation (extended brilliant Workplace). The threshold value can be used as a criterion to evaluate the lung tissue of mild COPD patients with emphysema.Early emphysema patients with normal PFT examination can also be found.
【學(xué)位授予單位】：青海大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R816.4;R563

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