Li Zhaobin, Xia Yi, Fang Yuan, Guan Yu, Wang Yun, Liu Shiyuan, Fan Li
Department of Radiation Oncology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Department of Radiology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Clin Respir J. 2019 Dec;13(12):741-750. doi: 10.1111/crj.13084. Epub 2019 Sep 30.
One-stop quantitative evaluation of emphysema and lung nodule in lung cancer screening is very important for patient.
To evaluate the quantitative emphysema in the large-sample low-dose CT lung cancer screening cohort with negative CT findings by subjective visual assessment.
One thousand, two hundred and thirty-one participants with negative visual evaluation were included in this retrospective study. The lungs were automatically segmented and the following were calculated: total lung volume (TLV), total emphysema volume (TEV), emphysema index (EI), 15th percentile lung density and mean lung density. EI ≥6% was defined as emphysema. The quantitative parameters were compared between different genders and ages. The quantitative parameters and risk factors were compared between emphysema and non-emphysema groups.
The proportion of smokers, TLV, TEV and EI of men were greater than that of women (P < 0.001). No correlation was found between age and volumes; the TEV and EI of people older than 60 years were greater than those younger than 60 years (P < 0.05) by age categorisation. One hundred and two participants showed emphysema, accounting for 8.29%. The incidence of emphysema in men was greater than that in women in total (P < 0.05). All the CT quantitative parameters were significantly different between emphysema and non-emphysema groups. The ratio of male, secondhand smoke exposure and chronic bronchitis history was greater in emphysema than that in the non-emphysema group (P < 0.05).
CT quantitative emphysema evaluation is recommended in people older than 60 years, especially in males, providing more precise information, aiding the early diagnosis of emphysema and informing early intervention.
在肺癌筛查中对肺气肿和肺结节进行一站式定量评估对患者非常重要。
通过主观视觉评估，对CT表现为阴性的大样本低剂量CT肺癌筛查队列中的肺气肿进行定量评估。
本回顾性研究纳入了1231名视觉评估为阴性的参与者。对肺部进行自动分割，并计算以下指标：总肺容积（TLV）、肺气肿总体积（TEV）、肺气肿指数（EI）、第15百分位数肺密度和平均肺密度。EI≥6%被定义为肺气肿。比较不同性别和年龄组之间的定量参数。比较肺气肿组和非肺气肿组的定量参数及危险因素。
男性吸烟者比例、TLV、TEV和EI均高于女性（P<0.001）。年龄与各体积指标之间未发现相关性；按年龄分类，60岁以上人群的TEV和EI高于60岁以下人群（P<0.05）。102名参与者表现为肺气肿，占8.29%。总体上男性肺气肿发病率高于女性（P<0.05）。肺气肿组和非肺气肿组的所有CT定量参数均有显著差异。肺气肿组男性比例、二手烟暴露和慢性支气管炎病史的比例高于非肺气肿组（P<0.05）。
建议对60岁以上人群，尤其是男性进行CT定量肺气肿评估，以提供更精确的信息，有助于肺气肿的早期诊断并为早期干预提供依据。
