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放射科医生的肺功能测试

Pulmonary Function Tests for the Radiologist.

作者信息

Tseng Hsiang-Jer, Henry Travis S, Veeraraghavan Srihari, Mittal Pardeep K, Little Brent P

机构信息

From the Department of Radiology and Imaging Sciences (H.J.T., P.K.M., B.P.L.) and Department of Medicine (S.V.), Emory University, 1364 Clifton Rd NE, Suite D125A, Atlanta, GA 30322; and Department of Radiology and Biomedical Imaging, University of California-San Francisco, San Francisco, Calif (T.S.H.).

出版信息

Radiographics. 2017 Jul-Aug;37(4):1037-1058. doi: 10.1148/rg.2017160174. Epub 2017 Jun 9.

Abstract

Pulmonary function tests (PFTs) provide important quantitative information about lung function and can be used to elucidate pathologic conditions responsible for respiratory symptoms, assess the severity and course of disease, and evaluate the patient for suitability and timing for lung transplantation. They are typically used in tandem with chest imaging, along with other ancillary data, to arrive at a specific diagnosis. PFTs may provide the radiologist with clues to the diagnosis and grading of a wide variety of pulmonary diseases. In this review, the authors discuss the clinical use of PFTs, their major components, and important measurements and graphical representations that are essential for understanding and interpreting the results. The key components of PFT panels-static lung volumes, dynamic lung function (spirometry), and diffusion capacity-are explained. The authors present a general algorithmic approach for problem solving, with recognition of common patterns of results (obstructive, restrictive, mixed, nonspecific, and normal). Pulmonary diseases from each of the major patterns and chest imaging are illustrated, and correlations between particular PFT results and disease severity and morphology at imaging are examined. Common pitfalls encountered during interpretation are also highlighted. A basic understanding of the mechanics of PFTs, characteristic patterns in important diseases, and correlation between lung function and imaging findings may assist the radiologist in diagnosis and follow-up of key pulmonary diseases and strengthen the radiologist's role as part of a multidisciplinary diagnostic team. Online supplemental material is available for this article. RSNA, 2017.

摘要

肺功能测试(PFTs)可提供有关肺功能的重要定量信息,可用于阐明导致呼吸道症状的病理状况、评估疾病的严重程度和病程,以及评估患者是否适合进行肺移植及确定移植时机。它们通常与胸部影像学检查以及其他辅助数据一起使用,以做出明确诊断。PFTs可为放射科医生提供诊断和分级多种肺部疾病的线索。在本综述中,作者讨论了PFTs的临床应用、其主要组成部分以及对于理解和解释结果至关重要的重要测量指标和图形表示。解释了PFT组合的关键组成部分——静态肺容量、动态肺功能(肺量计检查)和弥散能力。作者提出了一种通用的问题解决算法方法,识别常见的结果模式(阻塞性、限制性、混合性、非特异性和正常)。展示了每种主要模式的肺部疾病及胸部影像学表现,并研究了特定PFT结果与影像学上疾病严重程度和形态之间的相关性。还强调了解读过程中常见的陷阱。对PFTs的机制、重要疾病的特征模式以及肺功能与影像学表现之间的相关性有基本了解,可能有助于放射科医生对关键肺部疾病进行诊断和随访,并加强放射科医生作为多学科诊断团队一员的作用。本文提供在线补充材料。RSNA,2017年。

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