Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Thorac Imaging. 2012 May;27(3):164-70. doi: 10.1097/RTI.0b013e31822641c9.
We sought to determine the volume of each anatomic lung lobe reconstructed using 3-dimensional computed tomography (3D-CT) imaging from multidetector CT images and to compare these with pulmonary function test results.
We reviewed preoperative 3D-CT images and spirometry results of 111 patients (86 men and 25 women) with pulmonary neoplasms who were considered candidates for lung resections. On a 3D-CT image, the entire lung was semiautomatically separated into 5 anatomic lobes: right upper lobe, right middle lobe, right lower lobe, left upper lobe, and left lower lobe. For each lobe, total lobar volume, emphysematous lobar volume with low attenuation values of less than -950 HU, and normal lobar volume (NLV=total lobar volume-emphysematous lobar volume) were calculated. Vital capacity, forced expiratory volume in 1 second, and diffusing capacity for carbon monoxide (DLCO) were measured by spirometry. Relationships between NLV values of each lobe and pulmonary function results were determined by the Pearson correlation coefficients and multiple regression analysis.
The NLV values for both lower lobes (right lower lobe and left lower lobe) and the other lobes (right upper lobe, right middle lobe, and left upper lobe) were significantly correlated with vital capacity and forced expiratory volume in 1 second; lower lobes showed a stronger tendency toward these correlations. The NLV values of the lower lobes were significantly correlated with DLCO (P<0.001), although the NLV values of the other lobes were not correlated with DLCO (P=0.112).
Pulmonary function results, particularly DLCO, were primarily affected by the NLVs of the lower lobes.
我们旨在确定从多层螺旋 CT 图像重建的三维 CT (3D-CT)图像中每个解剖肺叶的体积,并将其与肺功能测试结果进行比较。
我们回顾了 111 例(86 名男性和 25 名女性)肺部肿瘤患者的术前 3D-CT 图像和肺功能检查结果,这些患者被认为是肺切除术的候选者。在 3D-CT 图像上,整个肺半自动地分为 5 个解剖叶:右上叶、右中叶、右下叶、左上叶和左下叶。对于每个叶,计算总叶体积、低衰减值小于-950 HU 的肺气肿叶体积和正常叶体积(NLV=总叶体积-肺气肿叶体积)。肺活量、1 秒用力呼气量和一氧化碳弥散量(DLCO)通过肺功能检查进行测量。通过 Pearson 相关系数和多元回归分析确定各叶的 NLV 值与肺功能结果之间的关系。
两个下叶(右下叶和左下叶)和其他叶(右上叶、右中叶和左上叶)的 NLV 值与肺活量和 1 秒用力呼气量显著相关;下叶的相关性更强。下叶的 NLV 值与 DLCO 显著相关(P<0.001),而其他叶的 NLV 值与 DLCO 不相关(P=0.112)。
肺功能结果,特别是 DLCO,主要受下叶 NLV 的影响。