Liu Jingming, Sun Zhaogang, Xie Ruming, Gao Mengqiu, Li Chuanyou
Beijing Key Laboratory of Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute No. 97 Ma Chang, Tongzhou District, 101149 Beijing, China.
Int J Clin Exp Med. 2015 Sep 15;8(9):15117-26. eCollection 2015.
The computed tomography (CT) manifestations in pulmonary tuberculosis (PTB) patients are complex and could not be quantitatively evaluated. We aimed to establish a new method to objectively measure the lung injury level in PTB by thoracic CT and make quantitative comparisons. In the retrospective study, a total of 360 adults were selected and divided into four groups according to their CT manifestations and medical history: Normal group, PTB group, PTB with diabetes mellitus (DM) group and Death caused by PTB group. Five additional patients who had continuous CT scans were chosen for preliminary longitudinal analysis. We established a new computer-aided CT volume measurement and comparison method for PTB patients (CACTV-PTB) which measured lung volume (LV) and thoracic volume (TV). RLT was calculated as the ratio of LV to TV and comparisons were performed among different groups. Standardized RLT (SRLT) was used in the longitudinal analysis among different patients. In the Normal group, LV and TV were positively correlated in linear regression (Ŷ=-0.5+0.46X, R(2)=0.796, P<0.01). RLT values were significantly different among four groups (Normal: 0.40±0.05, PTB: 0.37±0.08, PTB+DM: 0.34±0.06, Death: 0.23±0.04). The curves of SRLT value from different patients shared a same start point and could be compared directly. Utilizing the novel objective method CACTV-PTB makes it possible to compare the severity and dynamic change among different PTB patients. Our early experience also suggested that the lung injury is severer in the PTB+DM group than in the PTB group.
肺结核（PTB）患者的计算机断层扫描（CT）表现复杂，无法进行定量评估。我们旨在建立一种新方法，通过胸部CT客观测量PTB患者的肺损伤程度，并进行定量比较。在这项回顾性研究中，共选取了360名成年人，根据他们的CT表现和病史分为四组：正常组、PTB组、合并糖尿病（DM）的PTB组和PTB致死组。另外选取5名进行了连续CT扫描的患者进行初步纵向分析。我们为PTB患者建立了一种新的计算机辅助CT体积测量和比较方法（CACTV-PTB），该方法测量肺体积（LV）和胸廓体积（TV）。计算相对肺容积（RLT）为LV与TV的比值，并在不同组之间进行比较。标准化相对肺容积（SRLT）用于不同患者之间的纵向分析。在正常组中，LV和TV在线性回归中呈正相关（Ŷ=-0.5+0.46X，R(2)=0.796，P<0.01）。四组之间的RLT值有显著差异（正常组：0.40±0.05，PTB组：0.37±0.08，PTB+DM组：0.34±0.06，致死组：0.23±0.04）。不同患者的SRLT值曲线有相同的起点，可以直接比较。利用新的客观方法CACTV-PTB可以比较不同PTB患者之间的严重程度和动态变化。我们的早期经验还表明，PTB+DM组的肺损伤比PTB组更严重。
