Heussel C P, Achenbach T, Buschsieweke C, Kuhnigk J, Weinheimer O, Hammer G, Düber C, Kauczor H-U
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinik Mainz.
Rofo. 2006 Oct;178(10):987-98. doi: 10.1055/s-2006-926823.
The data records of thin-section MSCT of the lung with approx. 300 images are difficult to use in manual evaluation. A computer-assisted pre-diagnosis can help with reporting. Furthermore, post-processing techniques, for instance, for quantification of emphysema on the basis of three-dimensional anatomical information might be improved and the workflow might be further automated.
The results of 4 programs (Pulmo, Volume, YACTA and PulmoFUNC) for the quantitative analysis of emphysema (lung and emphysema volume, mean lung density and emphysema index) of 30 consecutive thin-section MSCT datasets with different emphysema severity levels were compared. The classification result of the YACTA program for different types of emphysema was also analyzed.
Pulmo and Volume have a median operating time of 105 and 59 minutes respectively due to the necessity for extensive manual correction of the lung segmentation. The programs PulmoFUNC and YACTA, which are automated to a large extent, have a median runtime of 26 and 16 minutes, respectively. The evaluation with Pulmo and Volume using 2 different datasets resulted in implausible values. PulmoFUNC crashed with 2 other datasets in a reproducible manner. Only with YACTA could all graphic datasets be evaluated. The lung volume, emphysema volume, emphysema index and mean lung density determined by YACTA and PulmoFUNC are significantly larger than the corresponding values of Volume and Pulmo (differences: Volume: 119 cm(3)/65 cm(3)/1 %/17 HU, Pulmo: 60 cm(3)/96 cm(3)/1 %/37 HU). Classification of the emphysema type was in agreement with that of the radiologist in 26 panlobular cases, in 22 paraseptalen cases and in 15 centrilobular emphysema cases.
The substantial expenditure of time obstructs the employment of quantitative emphysema analysis in the clinical routine. The results of YACTA and PulmoFUNC are affected by the dedicated exclusion of the tracheobronchial system. These fully automatic tools enable not only fast quantification without manual interaction, but also a reproducible measurement without user dependence.
肺部薄层MSCT约300幅图像的数据记录难以用于人工评估。计算机辅助预诊断有助于报告撰写。此外，基于三维解剖信息的后处理技术，例如肺气肿定量技术，可能会得到改进，工作流程也可能进一步自动化。
比较了4种程序（Pulmo、Volume、YACTA和PulmoFUNC）对30个连续的不同肺气肿严重程度的薄层MSCT数据集进行肺气肿定量分析（肺和肺气肿体积、平均肺密度和肺气肿指数）的结果。还分析了YACTA程序对不同类型肺气肿的分类结果。
由于肺分割需要大量人工校正，Pulmo和Volume的中位运行时间分别为105分钟和59分钟。在很大程度上自动化的PulmoFUNC和YACTA程序的中位运行时间分别为26分钟和16分钟。使用2个不同数据集用Pulmo和Volume进行评估得到的值不合理。PulmoFUNC在另外2个数据集上以可重复的方式崩溃。只有使用YACTA才能评估所有图形数据集。YACTA和PulmoFUNC确定的肺体积、肺气肿体积、肺气肿指数和平均肺密度明显大于Volume和Pulmo的相应值（差异：Volume：119 cm³/65 cm³/1%/17 HU，Pulmo：60 cm³/96 cm³/1%/37 HU）。在26例全小叶型、22例间隔旁型和15例小叶中心型肺气肿病例中，肺气肿类型的分类与放射科医生的分类一致。
大量的时间消耗阻碍了肺气肿定量分析在临床常规中的应用。YACTA和PulmoFUNC的结果受到气管支气管系统专门排除的影响。这些全自动工具不仅能够在无需人工干预的情况下快速定量，而且能够进行不依赖用户的可重复测量。
