de Lavernhe Isaure, Le Blanche Alain, Dégrugilliers Loïc, Carette Marie-France, Bayat Sam
Department of Pediatric Pulmonary Medicine, Amiens University Hospital, 1, Place Victor Pauchet, Amiens Cedex 1 80054, France.
University of Versailles Saint-Quentin-en-Yvelines, Unité de Formation et de Recherche de Médecine de Paris-Ile-de-France Ouest Simone Veil Versailles, France; Department of Diagnostic and Interventional Radiology, René Dubos Hospital, Paris, France.
Acad Radiol. 2015 Feb;22(2):179-85. doi: 10.1016/j.acra.2014.09.003. Epub 2014 Nov 11.
The progressive changes in lung morphology observed in cystic fibrosis (CF) can potentially affect the statistical distribution of computed tomography (CT) density values. This study aimed to characterize the lung CT density distributions by quantifying indices of the kurtosis and skewness of the lung density distribution and to compare these indices to radiologic scores and lung function parameters in children and young adults with CF.
CT scans and lung function of 26 patients with CF were retrospectively examined. The Bhalla radiologic scoring was performed separately, in random order, by two expert radiologists, blinded to the patient's identity, age, clinical status, results of lung function tests, and the other paired observer's score.
Positive relations were evidenced between the log indices of lung density distribution kurtosis (iKurtosis) and the overall radiologic scores (RS) of both observers (R = 0.58; P < .001 vs RS1 and R = 0.71; P < .001 vs RS2). A similar relationship was evidenced with the log index of the degree of distribution asymmetry (iSkewness; R = 0.62; P < .001 vs RS1 and R = 0.62; P < .001 vs RS2). Log-iKurtosis and log-iSkewness were related to FEV1 (R = -0.56; P < 10(-5) and R = -0.55; P < 10(-5)) and to residual volume (R = 0.40; P < .001 and R = 0.45; P < .001, respectively). Both radiologic scores showed significant relation with lung function. The correlation between RS1 and RS2 was excellent (R = 0.93), with a Cohen weighted kappa of 0.43.
Characteristic indices of lung CT density distribution are correlated to lung function and radiologic scores in patients with CF and merit further evaluation as part of more comprehensive automated methods for quantifying CF lung CT data.
在囊性纤维化（CF）中观察到的肺部形态学的渐进性变化可能会影响计算机断层扫描（CT）密度值的统计分布。本研究旨在通过量化肺密度分布的峰度和偏度指标来表征肺部CT密度分布，并将这些指标与CF儿童和青年的放射学评分及肺功能参数进行比较。
对26例CF患者的CT扫描和肺功能进行回顾性检查。由两名专家放射科医生以随机顺序分别进行Bhalla放射学评分，他们对患者的身份、年龄、临床状况、肺功能测试结果及另一配对观察者的评分均不知情。
肺密度分布峰度的对数指标（iKurtosis）与两位观察者的总体放射学评分（RS）之间均呈正相关（与RS1相比，R = 0.58；P <.001；与RS2相比，R = 0.71；P <.001）。分布不对称程度的对数指标（iSkewness）也呈现类似关系（与RS1相比，R = 0.62；P <.001；与RS2相比，R = 0.62；P <.001）。Log-iKurtosis和Log-iSkewness与第一秒用力呼气容积（FEV1）相关（R = -0.56；P < 10⁻⁵和R = -0.55；P < 10⁻⁵），与残气量相关（分别为R = 0.40；P <.001和R = 0.45；P <.001）。两种放射学评分均与肺功能显著相关。RS1和RS2之间的相关性极佳（R = 0.93），Cohen加权kappa为0.43。
CF患者肺部CT密度分布的特征指标与肺功能和放射学评分相关，作为更全面的CF肺部CT数据量化自动化方法的一部分，值得进一步评估。
