肺气肿患者低剂量薄层 CT 评估肺破坏和肺功能丧失的定量和定性研究。
Quantitative and qualitative assessments of lung destruction and pulmonary functional loss from reduced-dose thin-section CT in pulmonary emphysema patients.
机构信息
Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
出版信息
Acad Radiol. 2010 Feb;17(2):163-8. doi: 10.1016/j.acra.2009.08.009. Epub 2009 Nov 11.
RATIONALE AND OBJECTIVES
Academic and clinical interest in reducing radiation from computed tomography (CT) examinations has increased, and the purpose of this study was to determine the capabilities of reduced-dose multidetector-row CT (MDCT) in assessing lung destruction and pulmonary functional loss in pulmonary emphysema patients.
MATERIALS AND METHODS
Twenty-five consecutive smokers (15 men and 10 women; mean age 67.9 years; age range 49-86 years) underwent MDCT examinations using two different effective tube currents (standard-dose protocol [150 mAs] and reduced-dose protocol [50 mAs]). For quantitative and qualitative assessments of lung destruction in each subject, percentage of low attenuation emphysematous destruction areas (%LAAs) were computationally calculated, and visual emphysema scores (ESs) were determined for both protocols. To determine the capabilities for quantitative and qualitative assessments of lung destruction by using reduced-dose protocol, %LAAs and ESs of both protocols were compared statistically. To compare the capabilities for quantitative and qualitative assessments of pulmonary functional loss, %LAAs and ESs of both protocols were correlated with forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC).
RESULTS
%LAAs and ESs had significant correlations between both protocols (%LAAs: r = 0.95, P < .001; ESs: r = 0.97, P < .001). The limits of agreement of %LAAs were -1.8 + or - 9.2%. The agreement of ESs between both protocols was substantial (kappa = 0.70). %LAAs and ESs of both protocols had significant correlations with FEV1/FVC (%LAAs of 150 mAs: r = -0.49, P < .05; %LAAs of 50 mAs: r = -0.44, P < .05; ESs of 150 mAs: r = -0.67, P < .001; ESs of 50 mAs: r = -0.66, P < .001).
CONCLUSION
Reduced-dose MDCT had a potential of substitution for standard-dose MDCT on the both assessments in pulmonary emphysema patients.
背景与目的
学术和临床对降低计算机断层扫描（CT）检查的辐射量越来越感兴趣，本研究旨在评估低剂量多层螺旋 CT（MDCT）在评估肺气肿患者肺部破坏和肺功能丧失方面的能力。
材料与方法
25 例连续吸烟者（男 15 例，女 10 例；平均年龄 67.9 岁；年龄 49-86 岁）接受 MDCT 检查，采用两种不同的有效管电流（标准剂量方案[150 mAs]和低剂量方案[50 mAs]）。对每位受试者的肺部破坏进行定量和定性评估，计算低衰减肺气肿破坏区的百分比（%LAAs），并为两种方案确定视觉肺气肿评分（ES）。为了评估低剂量方案在定量和定性评估肺部破坏方面的能力，对两种方案的%LAAs 和 ES 进行了统计学比较。为了比较定量和定性评估肺功能丧失的能力，对两种方案的%LAAs 和 ES 与用力呼气量 1 秒（FEV1）/用力肺活量（FVC）进行了相关性分析。
结果
%LAAs 和 ES 两种方案之间存在显著相关性（%LAAs：r = 0.95，P <.001；ES：r = 0.97，P <.001）。%LAAs 的一致性范围为-1.8 + 或-9.2%。两种方案的 ES 一致性较好（kappa = 0.70）。%LAAs 和 ES 与 FEV1/FVC 均有显著相关性（150 mAs 组的%LAAs：r = -0.49，P <.05；50 mAs 组的%LAAs：r = -0.44，P <.05；150 mAs 组的 ES：r = -0.67，P <.001；50 mAs 组的 ES：r = -0.66，P <.001）。
结论
低剂量 MDCT 有潜力替代标准剂量 MDCT 对肺气肿患者进行这两种评估。
Zotero 插件