Department of Radiology, General Hospital of Ningxia Medical University, Ningxia, China.
Department of Pneumology, General Hospital of Ningxia Medical University, Ningxia, China.
Medicine (Baltimore). 2021 Nov 19;100(46):e27622. doi: 10.1097/MD.0000000000027622.
Patients with chronic obstructive pulmonary disease (COPD) have a reduced cross-sectional area (CSA) of small pulmonary vessels and decreased pulmonary function test (PFT) indexes. This study investigated the value of small pulmonary vessel CSA in diagnosing and evaluating the severity of COPD and its correlation with PFT.This retrospective case-control study included patients with COPD who underwent multi-slice spiral computed tomography (CT) between March 2015 and December 2018. COPD severity was graded. Patients with normal CT results were included as controls. The CSA of small pulmonary vessels at the sub-segmental (5-10 mm2) and sub-sub-segmental (<5 mm2) levels was measured. Receiver operating characteristic (ROC) curves were used to evaluate the effect of CSA for COPD risk prediction. The correlation between CSA% and PFT indexes was evaluated.There were 124 and 106 patients in the COPD and control groups, respectively. The %CSA <5 and %CSA5-10 were smaller in the COPD group than in controls (P < .05). The %CSA <5 in each subgroup stratified by COPD severity was smaller than in controls (P < .05). The % CSA5-10 was significantly smaller in the moderate and severe groups than in controls (P < .05). At 0.655%CSA <5 cut-off, the ROC area under the curve (AUC) was 0.765. For %CSA5-10, a 0.565 cut-off led to an AUC of 0.752. Both %CSA <5 and %CSA5-10 were positively correlated with all PFT indexes (r = 0.180-0.462, all P < .05).CSA was positively correlated with PFT. Analysis of small pulmonary vessel CSA based on CT images contributes to diagnosing and assessing the severity of COPD.
患者患有慢性阻塞性肺疾病 (COPD) 会有较小的肺血管横截面积 (CSA) 和降低的肺功能测试 (PFT) 指数。本研究探讨了小肺血管 CSA 在诊断和评估 COPD 严重程度及其与 PFT 的相关性中的价值。这项回顾性病例对照研究包括了 2015 年 3 月至 2018 年 12 月期间接受多层螺旋 CT（CT）的 COPD 患者。对 COPD 严重程度进行分级。将 CT 结果正常的患者纳入对照组。测量亚段（5-10mm2）和亚亚段（<5mm2）水平的小肺血管 CSA。使用受试者工作特征 (ROC) 曲线评估 CSA 对 COPD 风险预测的效果。评估 CSA%与 PFT 指数之间的相关性。COPD 组和对照组分别有 124 名和 106 名患者。COPD 组的 %CSA <5 和 %CSA5-10 小于对照组（P < .05）。根据 COPD 严重程度分层的每个亚组中，%CSA <5 都小于对照组（P < .05）。中重度组的 %CSA5-10 明显小于对照组（P < .05）。在 0.655%CSA <5 截止值下，ROC 曲线下面积 (AUC) 为 0.765。对于 %CSA5-10，0.565 截止值导致 AUC 为 0.752。%CSA <5 和 %CSA5-10 均与所有 PFT 指数呈正相关（r = 0.180-0.462，均 P < .05）。CSA 与 PFT 呈正相关。基于 CT 图像分析小肺血管 CSA 有助于诊断和评估 COPD 的严重程度。
