Radiology Department, Groupe Hospitalier Cochin-Hôtel Dieu, AP-HP, Université Paris Descartes - Sorbonne Paris Cité, Paris, France.
Department Diagnostic Imaging, Vinmec International Hospital - Central Park, Ho Chi Minh City, Vietnam.
BMC Pulm Med. 2018 Dec 18;18(1):194. doi: 10.1186/s12890-018-0758-6.
The present study aimed to develop an automated computed tomography (CT) score based on the CT quantification of high-attenuating lung structures, in order to provide a quantitative assessment of lung structural abnormalities in patients with Primary Ciliary Dyskinesia (PCD).
Adult (≥18 years) PCD patients who underwent both chest CT and spirometry within a 6-month period were retrospectively included. Commercially available lung segmentation software was used to isolate the lungs from the mediastinum and chest wall and obtain histograms of lung density. CT-density scores were calculated using fixed and adapted thresholds based on various combinations of histogram characteristics, such as mean lung density (MLD), skewness, and standard deviation (SD). Additionally, visual scoring using the Bhalla score was performed by 2 independent radiologists. Correlations between CT scores, forced expiratory volume in 1 s (FEV) and forced vital capacity (FVC) were evaluated.
Sixty-two adult patients with PCD were included. Of all histogram characteristics, those showing good positive or negative correlations to both FEV and FVC were SD (R = - 0.63 and - 0.67; p < 0.001) and Skewness (R = 0.67 and 0.67; p < 0.001). Among all evaluated thresholds, the CT-density score based on MLD + 1SD provided the best negative correlation with both FEV (R = - 0.68; p < 0.001) and FVC (R = - 0.71; p < 0.001), close to the correlations of the visual score (R = - 0.60; p < 0.001 for FEV and R = - 0.62; p < 0.001, for FVC).
Automated CT scoring of lung structural abnormalities lung in primary ciliary dyskinesia is feasible and may prove useful for evaluation of disease severity in the clinic and in clinical trials.
本研究旨在开发一种基于高衰减肺结构 CT 定量的自动化 CT 评分，以便对原发性纤毛运动障碍（PCD）患者的肺结构异常进行定量评估。
回顾性纳入在 6 个月内同时接受胸部 CT 和肺量测定的成年（≥18 岁）PCD 患者。使用商业上可用的肺部分割软件从纵隔和胸壁中分离出肺部，并获得肺部密度直方图。使用基于直方图特征（例如平均肺密度（MLD）、偏度和标准差（SD））的固定和自适应阈值计算 CT 密度评分。此外，由 2 名独立放射科医生使用 Bhalla 评分进行视觉评分。评估 CT 评分与用力呼气量（FEV）和用力肺活量（FVC）之间的相关性。
共纳入 62 例成年 PCD 患者。在所有直方图特征中，与 FEV 和 FVC 均呈良好正相关或负相关的是 SD（R = -0.63 和 -0.67；p < 0.001）和偏度（R = 0.67 和 0.67；p < 0.001）。在所有评估的阈值中，基于 MLD + 1SD 的 CT 密度评分与 FEV（R = -0.68；p < 0.001）和 FVC（R = -0.71；p < 0.001）均呈负相关，与视觉评分的相关性接近（FEV 为 R = -0.60；p < 0.001，FVC 为 R = -0.62；p < 0.001）。
原发性纤毛运动障碍中肺结构异常的自动 CT 评分是可行的，可能对临床和临床试验中评估疾病严重程度有用。
