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评估系统性硬皮病相关性间质性肺炎患者高分辨率 CT 下磨玻璃影程度:定量与定性分析比较。

Evaluation of the extent of ground-glass opacity on high-resolution CT in patients with interstitial pneumonia associated with systemic sclerosis: comparison between quantitative and qualitative analysis.

机构信息

Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.

Department of Clinical Radiology, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.

出版信息

Clin Radiol. 2014 Jul;69(7):758-64. doi: 10.1016/j.crad.2014.03.008. Epub 2014 May 10.

DOI:10.1016/j.crad.2014.03.008
PMID:24824977
Abstract

AIM

To verify whether quantitative analysis of the extent of ground-glass opacity (GGO) on high-resolution computed tomography (HRCT) could show a stronger correlation with the therapeutic response of interstitial pneumonia (IP) associated with systemic sclerosis (SSc) compared with qualitative analysis.

MATERIALS AND METHODS

Seventeen patients with IP associated with SSc received autologous peripheral blood stem cell transplantation (auto-PBSCT) and were followed up using HRCT and pulmonary function tests. Two thoracic radiologists assessed the extent of GGO on HRCT using a workstation. Therapeutic effect was assessed using the change of vital capacity (VC) and diffusing capacity of the lung for carbon monoxide (DLco) before and 12 months after PBSCT. Interobserver agreement was assessed using Spearman's rank correlation coefficient and the Bland-Altman method. Correlation with the therapeutic response between quantitative and qualitative analysis was assessed with Pearson's correlation coefficients.

RESULTS

Spearman's rank correlation coefficient showed good agreement, but Bland-Altman plots showed that proportional error could be suspected. Quantitative analysis showed stronger correlation than the qualitative analysis based on the relationships between the change in extent of GGO and VC, and change in extent of GGO and DLco.

CONCLUSION

Quantitative analysis of the change in extent of GGO showed stronger correlation with the therapeutic response of IP with SSc after auto-PBSCT than with the qualitative analysis.

摘要

目的

验证高分辨率计算机断层扫描(HRCT)上磨玻璃密度(GGO)程度的定量分析与系统性硬皮病相关间质性肺炎(IP)的治疗反应之间的相关性是否强于定性分析。

材料和方法

17 例 IP 合并 SSc 患者接受了自体外周血造血干细胞移植(auto-PBSCT),并通过 HRCT 和肺功能测试进行随访。两名胸部放射科医生使用工作站评估 HRCT 上 GGO 的程度。治疗效果通过 PBSCT 前和 12 个月后肺活量(VC)和一氧化碳弥散量(DLco)的变化来评估。采用 Spearman 秩相关系数和 Bland-Altman 法评估观察者间的一致性。采用 Pearson 相关系数评估定量和定性分析与治疗反应之间的相关性。

结果

Spearman 秩相关系数显示出良好的一致性,但 Bland-Altman 图显示可能存在比例误差。定量分析显示,与定性分析相比,基于 GGO 程度变化与 VC 变化、GGO 程度变化与 DLco 变化之间的关系,与 SSc 后自体-PBSCT 治疗反应的相关性更强。

结论

与定性分析相比,auto-PBSCT 后,GGO 程度变化的定量分析与 SSc 相关 IP 的治疗反应相关性更强。

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