Biehler Jonas, Brei Marie, Pischke Nina, Rasch Sebastian, Dibos Miriam, Erber Johanna, Schmid Roland M, Braren Rickmer F, Makowski Markus R, Wichmann Karl-Robert, Mueller Kei Wieland, Wall Wolfgang A, Lahmer Tobias
Institute for Computational Mechanics, Technical University Munich, Boltzmannstr. 15, 85748, Munich, Germany.
Ebenbuild GmbH, Holzstraße. 28, 80469, Munich, Germany.
Intensive Care Med Exp. 2025 May 19;13(1):52. doi: 10.1186/s40635-025-00752-w.
This study aimed to approximate the level of extravascular lung water (EVLW) in patients with severe COVID-19 pneumonia using quantitative imaging techniques. The elevation of EVLW is known to correlate with the degree of diffuse alveolar damage and linked with the mortality of critically ill patients. Transpulmonary thermodilution (TPTD) is the gold standard technique to estimate the total amount of EVLW, but it is invasive and requires specialized equipment and trained personnel.
The study included patients with severe COVID-19 who required chest CT scanning within the first 48 h of Intensive Care Unit (ICU) admission and had TPTD monitoring. Using in-house software tools for automatic semantic segmentation, lung masks were obtained for estimating the EVLW content. The results were compared with the TPTD measurements.
The results demonstrate a significant correlation between EVLW-TPTP measured by thermodilution and EVLW-CT estimated from the patient's CT-image (r = 0.629, p = 0.0014).
The study showed that quantitative imaging techniques using chest CT-scans could be used as a convenient and low-cost option for ICUs without TPTD equipment for the assessment of EVLW in severe COVID-19 pneumonia.
本研究旨在使用定量成像技术估算重症新型冠状病毒肺炎（COVID-19）患者的血管外肺水（EVLW）水平。已知EVLW升高与弥漫性肺泡损伤程度相关，并与危重症患者的死亡率有关。经肺热稀释法（TPTD）是估算EVLW总量的金标准技术，但它具有侵入性，需要专门设备和经过培训的人员。
该研究纳入在重症监护病房（ICU）入院后48小时内需要进行胸部CT扫描且接受TPTD监测的重症COVID-19患者。使用内部软件工具进行自动语义分割，获取肺掩码以估算EVLW含量。将结果与TPTD测量值进行比较。
结果表明，通过热稀释法测量的EVLW-TPTP与根据患者CT图像估算的EVLW-CT之间存在显著相关性（r = 0.629，p = 0.0014）。
该研究表明，对于没有TPTD设备的ICU，使用胸部CT扫描的定量成像技术可作为一种方便且低成本的方法，用于评估重症COVID-19肺炎患者的EVLW。
