Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD; Rush Medical College, Rush University Medical Center, Chicago, IL.
Radiology and Imaging Sciences Department, National Institutes of Health, Bethesda, MD.
Chest. 2019 May;155(5):962-971. doi: 10.1016/j.chest.2019.01.004. Epub 2019 Jan 17.
In lymphangioleiomyomatosis (LAM), infiltration of the lungs with smooth muscle-like LAM cells results in cystic destruction and decline in lung function, effects stabilized by sirolimus therapy. LAM lung disease is followed, in part, by high-resolution CT scans. To obtain further information from these scans, we quantified changes in lung parenchyma by analyzing image "texture."
Twenty-six texture properties were quantified by analyzing the distribution and intensity of pixels with a computer-aided system. Both cross-sectional and longitudinal studies were performed to examine the relationships between texture properties, cyst score (percentage of lung occupied by cysts), FEV, and diffusion capacity for carbon monoxide (Dlco), and to determine the effect of sirolimus treatment.
In the cross-sectional study, 18 texture properties showed significant positive correlations with cyst score. Cyst score and 13 of the 18 texture properties showed significant differences in rates of change after sirolimus treatment; 11 also significantly predicted FEV and Dlco.
Increased cyst score was associated with increased texture degradation near cysts. Sirolimus treatment improved lung texture surrounding cysts and stabilized cyst score. Eleven texture properties were associated with FEV, Dlco, cyst score, and response to sirolimus. Texture analysis may be valuable in evaluating LAM severity and treatment response.
在淋巴管平滑肌瘤病（LAM）中，肺部平滑肌样 LAM 细胞的浸润导致囊性破坏和肺功能下降，西罗莫司治疗可稳定这些影响。LAM 肺部疾病部分通过高分辨率 CT 扫描进行随访。为了从这些扫描中获得更多信息，我们通过分析图像“纹理”来量化肺实质的变化。
通过计算机辅助系统分析像素的分布和强度，定量了 26 种纹理特性。进行了横断面和纵向研究，以检查纹理特性、囊肿评分（肺内囊肿所占百分比）、FEV 和一氧化碳弥散量（Dlco）之间的关系，并确定西罗莫司治疗的效果。
在横断面研究中，有 18 种纹理特性与囊肿评分呈显著正相关。囊肿评分和 18 种纹理特性中的 13 种在西罗莫司治疗后的变化率上存在显著差异；其中 11 种也显著预测了 FEV 和 Dlco。
增加的囊肿评分与囊肿附近的纹理降解增加有关。西罗莫司治疗改善了囊肿周围的肺纹理并稳定了囊肿评分。11 种纹理特性与 FEV、Dlco、囊肿评分和对西罗莫司的反应相关。纹理分析可能在评估 LAM 严重程度和治疗反应方面具有价值。
