CT定量成像評(píng)估肺氣腫的臨床應(yīng)用價(jià)值
發(fā)布時(shí)間：2019-06-20 04:43
【摘要】：目的 分析MSCT不同重建算法對(duì)于肺氣腫CT定量測(cè)定結(jié)果的影響。對(duì)比肺密度定量測(cè)定與視覺評(píng)分結(jié)果兩種方法對(duì)不同程度肺氣腫的評(píng)估價(jià)值。 對(duì)象和方法 天津市海河醫(yī)院2009年12月～2010年3月確診COPD病例30例,行胸部MSCT掃描(男20例,年齡51-88歲,平均年齡70.5±8.94歲；女10例,年齡53～84歲,平均年齡71.1±7.46歲),原始數(shù)據(jù)分別經(jīng)標(biāo)準(zhǔn)算法、肺算法及銳利算法重建組成標(biāo)準(zhǔn)算法組、肺算法組及銳利算法組,采用后處理技術(shù)對(duì)圖像進(jìn)行重組、分割并保留雙肺部分,測(cè)定肺氣腫指數(shù)(emphysema index, EI)、全肺平均肺衰減值(mean lung attenuation, MLA)及全肺容積(total lung volume, TLV),比較標(biāo)準(zhǔn)算法組、肺算法組及銳利算法組之間EI、MLA及TLV的差異性。采用相同掃描參數(shù)對(duì)一均勻水模行MSCT掃描10次,測(cè)量不同算法圖像的平均密度、密度標(biāo)準(zhǔn)差、密度最大值和密度最小值的平均值。 天津市海河醫(yī)院2010年3月～2010年10月確診COPD病例30例,行胸部MSCT掃描。依照RV/TLC值分成輕度肺氣腫組(A組)與中、重度肺氣腫組(B組)。A組：RV/TLC40%且50%,其中男11例,女4例,年齡53-88歲,平均年齡67.27±11.11歲。B組：RV/TLC50%,其中男10例,女5例,年齡51-84歲,平均年齡68.73±10.17歲。對(duì)此30例肺氣腫病人進(jìn)行胸部MSCT掃描。由3位醫(yī)師分別測(cè)量肺氣腫指數(shù)(EI),計(jì)算視覺評(píng)分分?jǐn)?shù)(VS),同時(shí)記錄兩種方法所需時(shí)間。對(duì)A、B兩組不同醫(yī)師間所得到結(jié)果的差異性與相關(guān)性進(jìn)行比較。對(duì)A、B兩組的EI與VS的相關(guān)性分別進(jìn)行比較。對(duì)肺密度定量測(cè)量和視覺評(píng)分所需時(shí)間進(jìn)行比較。 結(jié)果 EI在不同重建算法各組之間的差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。MLA標(biāo)準(zhǔn)算法組與銳利算法組之間的差異沒有統(tǒng)計(jì)學(xué)意義(P0.05),其它各組之間差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。SDMLA各組之間差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。 TLV各組之間的差異均不存在統(tǒng)計(jì)學(xué)意義(P0.05)。水模測(cè)量結(jié)果發(fā)現(xiàn)銳利算法測(cè)量所得平均密度更加接近于水的密度,標(biāo)準(zhǔn)算法測(cè)量平均密度與銳利算法相近。標(biāo)準(zhǔn)算法、肺算法及銳利算法測(cè)量密度標(biāo)準(zhǔn)差及最大值、最小值呈遞增趨勢(shì)。 醫(yī)師之間肺密度定量測(cè)量結(jié)果的一致性好于視覺評(píng)分結(jié)果的一致性(r=0.99-1.00VS r=0.35-0.97, P0.05)。視覺評(píng)分結(jié)果醫(yī)師之間的一致性,B組好于A組(r=0.73～0.97VS r=0.35-0.77, P0.05),肺密度定量測(cè)量結(jié)果的一致性A、B兩組之間差異極小(r=0.99～1.00VS r=0.98-0.99, P0.05)。B組病人EI與VS的相關(guān)性好于A組病人EI與VS的相關(guān)性(r=0.725VS r=0.317, P0.05).肺密度定量測(cè)量平均時(shí)間為7.88±0.80min,視覺評(píng)分平均時(shí)間為4.42±0.40min,二者之間差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論 ①肺氣腫CT定量測(cè)定中不同原始數(shù)據(jù)重建算法的選擇能夠影響EI值、MLA值,而對(duì)TLV值的影響不大。 ②標(biāo)準(zhǔn)重建算法更適用于MSCT肺氣腫CT定量測(cè)定。 ③肺密度定量測(cè)量與視覺評(píng)分結(jié)果之間具有相關(guān)性。肺氣腫定量測(cè)量較視覺評(píng)分相比醫(yī)師之間評(píng)估結(jié)果的一致性更高。 ④肺氣腫視覺評(píng)分結(jié)果的一致性較差,特別是輕度肺氣腫時(shí)。對(duì)輕度肺氣腫病人進(jìn)行評(píng)估與隨訪時(shí)應(yīng)采用定量測(cè)量方法。
[Abstract]:Purpose Analysis of the effect of different reconstruction algorithms of MSCT on the quantitative determination of emphysema CT The evaluation of different degree of emphysema by comparing the quantitative and visual scores of the lung density with the results of visual scoring value. Yes image and method,30 cases of COPD were diagnosed from December of 2009 to March 2010, and 30 cases of COPD were diagnosed by MSCT (male in 20, age 51-88 years, mean age 70.5-8.94 years), female 10 cases (age 53-84 years, mean age 71.1 and 7.46 years), and raw data The standard algorithm, the lung algorithm and the sharp algorithm are used to reconstruct the standard algorithm group, the lung algorithm group and the sharp algorithm group, and the post-processing technique is adopted to carry out the recombination, segmentation and retention of the double-lung part of the image, the emphysema index (EI) and the mean lung average lung attenuation value (mean lung attunu) are measured. The EI, MLA and TL between the standard algorithm group, the lung algorithm group and the sharp algorithm group were compared by the total lung volume (TLV), the total lung volume (TLV), the comparison standard algorithm group, the lung algorithm group and the sharp algorithm group. The difference of V is that the average density, the density standard deviation, the density maximum and the density of the image of a uniform water model are measured by the same scanning parameters for 10 times, and the average density, the density standard deviation, the density maximum and the density of the images of different algorithms are measured. Mean value of the value.30 cases of COPD diagnosed by Tianjin Haihe Hospital from March 2010 to October 2010, and chest and chest Partial MSCT scan. divided into mild emphysema group (group A) and moderate and severe lung in accordance with the RV/ TLC values Group A: RV/ TLC40% and 50%, male 11, female 4, age 53-88, mean age 67.27 11.11-year-old. Group B: RV/ TLC50%, male 10, female 5, age 51-84, mean age 68.73 The chest was 10.17 years old. In this 30 cases of emphysema, the patient was treated with a chest Part MSCT scans. The emphysema index (EI) was measured by 3 physicians, and the visual score (VS) was calculated, and both were recorded. The time required for the method. The difference of the results obtained between the two groups in group A and group B was the same as that of the two groups. The correlation is compared. The correlation between the EI and VS in both groups A and B Comparison of the sex of the lung, the quantitative measurement of the lung density and the visual score On-demand Results The difference between the group of the MLA standard algorithm group and the sharp algorithm group was not unified. The difference between the other groups was statistically significant (P0.05). The difference between the TLVs and the TLVs does not exist. The measurement results of the water model show that the average density obtained by the sharp algorithm is closer to the density of water, and the standard algorithm measures The average density is similar to the sharp algorithm. The standard algorithm, the lung algorithm and the sharp algorithm measure the density standard deviation and the most The minimum value is increasing. The consistency of the quantitative measurement of the lung density between the physicians is better than the consistency of the visual scoring results (r = 0.99-1.00 VS r = 0.3 5-0.97, P0.05). The consistency between the visual score and the physician, group B was better in group A (r = 0.73-0.97 VS r = 0.35-0.77, P0.05), and the difference between the two groups was very small (r = 0.99-1.00 VS r = 0.9). The correlation between EI and VS in group B was better than that in group A (r = 0.725 VS r). The mean time of the quantitative measurement of lung density was 7.88-0.80 min and the mean time of visual scoring was 4.42-0.40 min. a series of Conclusion The selection of different raw data reconstruction algorithms in the quantitative determination of emphysema in emphysema can influence the EI value. And the value of the TLV is not affected by the value of the TLV. The algorithm is more suitable for the quantitative determination of MSCT emphysema. The relationship between the quantitative measurement of lung density and the results of visual scoring. Quantitative measurement of emphysema A higher degree of consistency in the results of the assessment between the physicians as compared to the visual score. Poor consistency in the results of the swelling visual scoring, especially in mild emphysema.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R816.4
本文編號(hào)：2502941
[Abstract]:Purpose Analysis of the effect of different reconstruction algorithms of MSCT on the quantitative determination of emphysema CT The evaluation of different degree of emphysema by comparing the quantitative and visual scores of the lung density with the results of visual scoring value. Yes image and method,30 cases of COPD were diagnosed from December of 2009 to March 2010, and 30 cases of COPD were diagnosed by MSCT (male in 20, age 51-88 years, mean age 70.5-8.94 years), female 10 cases (age 53-84 years, mean age 71.1 and 7.46 years), and raw data The standard algorithm, the lung algorithm and the sharp algorithm are used to reconstruct the standard algorithm group, the lung algorithm group and the sharp algorithm group, and the post-processing technique is adopted to carry out the recombination, segmentation and retention of the double-lung part of the image, the emphysema index (EI) and the mean lung average lung attenuation value (mean lung attunu) are measured. The EI, MLA and TL between the standard algorithm group, the lung algorithm group and the sharp algorithm group were compared by the total lung volume (TLV), the total lung volume (TLV), the comparison standard algorithm group, the lung algorithm group and the sharp algorithm group. The difference of V is that the average density, the density standard deviation, the density maximum and the density of the image of a uniform water model are measured by the same scanning parameters for 10 times, and the average density, the density standard deviation, the density maximum and the density of the images of different algorithms are measured. Mean value of the value.30 cases of COPD diagnosed by Tianjin Haihe Hospital from March 2010 to October 2010, and chest and chest Partial MSCT scan. divided into mild emphysema group (group A) and moderate and severe lung in accordance with the RV/ TLC values Group A: RV/ TLC40% and 50%, male 11, female 4, age 53-88, mean age 67.27 11.11-year-old. Group B: RV/ TLC50%, male 10, female 5, age 51-84, mean age 68.73 The chest was 10.17 years old. In this 30 cases of emphysema, the patient was treated with a chest Part MSCT scans. The emphysema index (EI) was measured by 3 physicians, and the visual score (VS) was calculated, and both were recorded. The time required for the method. The difference of the results obtained between the two groups in group A and group B was the same as that of the two groups. The correlation is compared. The correlation between the EI and VS in both groups A and B Comparison of the sex of the lung, the quantitative measurement of the lung density and the visual score On-demand Results The difference between the group of the MLA standard algorithm group and the sharp algorithm group was not unified. The difference between the other groups was statistically significant (P0.05). The difference between the TLVs and the TLVs does not exist. The measurement results of the water model show that the average density obtained by the sharp algorithm is closer to the density of water, and the standard algorithm measures The average density is similar to the sharp algorithm. The standard algorithm, the lung algorithm and the sharp algorithm measure the density standard deviation and the most The minimum value is increasing. The consistency of the quantitative measurement of the lung density between the physicians is better than the consistency of the visual scoring results (r = 0.99-1.00 VS r = 0.3 5-0.97, P0.05). The consistency between the visual score and the physician, group B was better in group A (r = 0.73-0.97 VS r = 0.35-0.77, P0.05), and the difference between the two groups was very small (r = 0.99-1.00 VS r = 0.9). The correlation between EI and VS in group B was better than that in group A (r = 0.725 VS r). The mean time of the quantitative measurement of lung density was 7.88-0.80 min and the mean time of visual scoring was 4.42-0.40 min. a series of Conclusion The selection of different raw data reconstruction algorithms in the quantitative determination of emphysema in emphysema can influence the EI value. And the value of the TLV is not affected by the value of the TLV. The algorithm is more suitable for the quantitative determination of MSCT emphysema. The relationship between the quantitative measurement of lung density and the results of visual scoring. Quantitative measurement of emphysema A higher degree of consistency in the results of the assessment between the physicians as compared to the visual score. Poor consistency in the results of the swelling visual scoring, especially in mild emphysema.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R816.4
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