Xia Ziyang, Peng Chuming, Fan Liyuan, Chen Qiongzhu, Liu Wentao, Ma Ting, Chen Weicong, Wen Yaocheng, Song Yuquan, Lin Haibo
Department of Radiology, National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Quant Imaging Med Surg. 2024 Aug 1;14(8):5591-5601. doi: 10.21037/qims-24-90. Epub 2024 Jul 26.
Dynamic chest radiography (DCR) is a novel and supplementary examination in respiratory diseases. The investigation of other chest diseases using DCR has been explored, identifying a certain correlation of the pulmonary function test (PFT). However, there is a lack of research using DCR parameters to quantitatively evaluate chest disease. The purpose of this study was to investigate the diagnostic value of DCR for diaphragm paralysis (DP).
This retrospective study recruited 118 participants, which include 18 patients with DP, 48 healthy volunteers, and 52 patients with respiratory disease. Comparison of DCR parameters relationships among 3 groups was performed using one-way analysis of variance (ANOVA) and Kruskal-Wallis test. The receiver operating characteristic (ROC) curve was used to compare the value of the DCR parameters to diagnose DP.
The differences of excursion of diaphragm (ED) in normal (nb) and forced breathing (fb), ED(fb)-ED(nb), and the parameters of projected lung area (PLA) in inspiratory (ins) and expiratory phase (exp), PLA.exp(fb), PLA.ins(fb)-PLA.ins(nb), and PLA.exp(fb)-PLA.exp(nb) among the 3 groups were statistically significant. The highest area under the curve (AUC) of right-side parameter was the ED(fb)-ED(nb), for which the AUC was 0.8950 [95% confidence interval (CI): 0.7618-1.000], whereas that of the left-side parameter was ED(fb), for which the AUC was 0.9176 [95% confidence interval (CI): 0.8524-0.9829].
The parameters of DCR have good diagnostic value for DP. The highest diagnostic efficiency for DP on the right side is the ED(fb)-ED(nb), with a sensitivity of 95% and a specificity of 78.6%, whereas on the left side is ED(fb), with a sensitivity of 80% and a specificity of 88.2%.
动态胸部X线摄影（DCR）是呼吸系统疾病的一种新型辅助检查。已探索使用DCR对其他胸部疾病进行研究，发现其与肺功能测试（PFT）存在一定相关性。然而，缺乏利用DCR参数对胸部疾病进行定量评估的研究。本研究旨在探讨DCR对膈肌麻痹（DP）的诊断价值。
本回顾性研究招募了118名参与者，包括18例DP患者、48名健康志愿者和52例呼吸系统疾病患者。采用单因素方差分析（ANOVA）和Kruskal-Wallis检验对3组之间的DCR参数关系进行比较。采用受试者工作特征（ROC）曲线比较DCR参数对DP的诊断价值。
3组之间在正常呼吸（nb）和用力呼吸（fb）时膈肌移动度（ED）的差异、ED（fb）-ED（nb），以及吸气（ins）和呼气期（exp）的预计肺面积（PLA）参数、PLA.exp（fb）、PLA.ins（fb）-PLA.ins（nb）和PLA.exp（fb）-PLA.exp（nb）具有统计学意义。右侧参数曲线下面积（AUC）最高的是ED（fb）-ED（nb），其AUC为0.8950 [95%置信区间（CI）：0.7618 - 1.000]，而左侧参数曲线下面积最高的是ED（fb），其AUC为0.9176 [95%置信区间（CI）：0.8524 - 0.9829]。
DCR参数对DP具有良好的诊断价值。右侧对DP诊断效率最高的是ED（fb）-ED（nb），敏感性为95%，特异性为78.6%；左侧是ED（fb），敏感性为80%，特异性为88.2%。
