Eterović D, Dujić Z, Tocilj J, Capkun V
Department of Nuclear Medicine, Clinical Hospital Split, Republic of Croatia.
Br J Ind Med. 1993 Jun;50(6):514-9. doi: 10.1136/oem.50.6.514.
A new method for quantitative evaluation for high resolution computed tomography (HRCT) of the lungs was developed by assessment of the distribution of radiological densities within the lung slices. To enable effective reduction of data and improve the sensitivity of detection of abnormalities, the density distributions were analysed by curve fitting through the gamma variate model. The output of two variables proved most representative: the most frequent density (Hoansfield units; HU) and width of distribution (HU). The method was applied to seven patients with early asbestosis (positive histological finding and International Labour Office (ILO) profusion score up to 0/1), 15 patients with advanced stage of asbestosis (positive histological finding and ILO score above 1/2), and 13 normal controls. All patients with early asbestosis had isolated reduction of diffusing lung capacity to carbon monoxide (DLCO), whereas all patients with advanced asbestosis had reduced DLCO and restrictive disease; two of them also had an obstruction pattern. The most frequent densities were significantly greater in the advanced asbestosis group (-567 HU) when compared with both the early asbestosis group (-719 HU; p = 2 x 10(-6)), and controls (-799 HU; p = 0), and they also discriminated significantly between the early asbestosis group and controls (p = 0.0002). Significantly stronger linear correlations were established between DLCO and the most frequent densities (r = 0.86) than between DLCO and HRCT score (r = 0.57) or ILO score (r = 0.34). It is concluded that fitting the curve of the density distribution enables a more objective assessment of HRCT pulmonary scans, especially in the early stage of asbestosis.
通过评估肺切片内放射密度的分布，开发了一种用于肺部高分辨率计算机断层扫描（HRCT）定量评估的新方法。为了有效减少数据并提高异常检测的灵敏度，通过伽马变量模型进行曲线拟合来分析密度分布。结果证明，两个变量的输出最具代表性：最常见密度（亨氏单位；HU）和分布宽度（HU）。该方法应用于7例早期石棉肺患者（组织学检查阳性且国际劳工组织（ILO）肺野密集度评分达0/1）、15例晚期石棉肺患者（组织学检查阳性且ILO评分高于1/2）以及13名正常对照者。所有早期石棉肺患者的肺一氧化碳弥散量（DLCO）均单独降低，而所有晚期石棉肺患者的DLCO均降低且存在限制性疾病；其中2例还伴有阻塞性模式。与早期石棉肺组（-719 HU；p = 2×10⁻⁶）和对照组（-799 HU；p = 0）相比，晚期石棉肺组的最常见密度（-567 HU）显著更高，并且它们在早期石棉肺组和对照组之间也有显著差异（p = 0.0002）。DLCO与最常见密度之间建立的线性相关性（r = 0.86）明显强于DLCO与HRCT评分（r = 0.57）或ILO评分（r = 0.34）之间的相关性。结论是，对密度分布曲线进行拟合能够更客观地评估HRCT肺部扫描，尤其是在石棉肺的早期阶段。
