慢性阻塞性肺疾病CT定量评估研究进展
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摘要
近年来,定量CT逐渐成为评估慢性阻塞性肺疾病(COPD)的新方法。定量CT克服了临床肺功能检查只能评估患者肺部整体情况的不足,可分析肺部细微结构的改变。定量CT可直接评估COPD患者肺气肿情况,并可通过测量气道相关参数、空气潴留情况以及血管情况,直接或间接反映气道的病变情况。此外,定量CT评估获得的相关参数也与肺功能部分指标存在一定的相关性。未来定量CT将向着更精确的测量方法和更低的辐射剂量方向发展,从而为COPD治疗和预后提供更大的帮助。
In recent years,quantitative CT has become a new method in evaluating chronic obstructive pulmonary disease( COPD). Quantitative CT overcomes the deficiency that pulmonary function test only evaluates the overall pulomonary conditions,and can analyze the changes of pulmonary microscopic structures. Quantitative CT can evaluate pulmonary emphysema in COPD patients directly and measure airway relevant parameters,air trapping and vascular conditions to reflect airway diseases directly or indirectly. There are also certain correlations between these quantitative CT evaluation results and some pulmonary functional parameters. Quantitative CT will develop towards higher accurate measurement and lower radiation dose,so as to provide more help for the COPD treatment and prognosis.
In recent years,quantitative CT has become a new method in evaluating chronic obstructive pulmonary disease( COPD). Quantitative CT overcomes the deficiency that pulmonary function test only evaluates the overall pulomonary conditions,and can analyze the changes of pulmonary microscopic structures. Quantitative CT can evaluate pulmonary emphysema in COPD patients directly and measure airway relevant parameters,air trapping and vascular conditions to reflect airway diseases directly or indirectly. There are also certain correlations between these quantitative CT evaluation results and some pulmonary functional parameters. Quantitative CT will develop towards higher accurate measurement and lower radiation dose,so as to provide more help for the COPD treatment and prognosis.
引文
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[3]Montes de Oca M,Pérez-Padilla R.Global initiative for chronic obstructive lung disease(gold)-2017:The alat perspective[J].Arch Bronconeumol,2017,53(3):87-88.
[4]Cho YH,Seo JB,Kim N,et al.Comparison of a new integralbased half-band method for CT measurement of peripheral airways in copd with a conventional full-width half-maximum method using both phantom and clinical CT images[J].J Comput Assist Tomogr,2015,39(3):428-436.
[5]Lynch DA,Austin JH,Hogg JC,et al.CT-definable subtypes of chronic obstructive pulmonary disease:A statement of the fleischner society[J].Radiology,2015,277(1):192-205.
[6]高永炳,龚波,武洪林,等.慢性阻塞性肺疾病肺通气功能与CT肺气肿指数的研究[J].医学影像学杂志,2016,26(12):2224-2227.
[7]Saure EW,Bakke PS,Lind Eagan TM,et al.Diffusion capacity and CT measures of emphysema and airway wall thickness-relation to arterial oxygen tension in COPD patients[J].Eur Clin Respir J,2016(3):29141.
[8]张迪,管宇,范丽,等.吸烟者多层螺旋CT双呼吸相肺气肿、空气潴留定量及与肺功能的相关性分析[J].中华医学杂志,2018,98(19):1467-1473.
[9]Shaikh M,Sood RG,Sarkar M,et al.Quantitative computed tomography(CT)assessment of emphysema in patients with severe chronic obstructive pulmonary disease(copd)and its correlation with age,sex,pulmonary function tests,BMI,smoking,and biomass exposure[J].Pol J Radiol,2017(82):760-766.
[10]Müller J,Lim HJ,Eichinger M,et al.Influence of fissure integrity on quantitative CT and emphysema distribution in emphysematype copd using a dedicated copd software[J].Eur J Radiol,2017(95):293-299.
[11]阎超群,张攀,史达,等.基于高分辨率CT对慢性阻塞性肺疾病的定量测量与临床肺功能对照研究[J].实用医学杂志,2016,32(8):1258-1261.
[12]杨飞,纪蒙蒙,朱晓龙,等.右肺上叶尖段及其亚段支气管CT定量参数对慢性阻塞性肺疾病病情的评估价值[J].山东医药,2018,58(12):14-17.
[13]Nambu A,Zach J,Schroeder J,et al.Quantitative computed tomography measurements to evaluate airway disease in chronic obstructive pulmonary disease:Relationship to physiological measurements,clinical index and visual assessment of airway disease[J].Eur JRadiol,2016,85(11):2144-2151.
[14]Ostridge K,Williams NP,Kim V,et al.Relationship of CT-quantified emphysema,small airways disease and bronchial wall dimensions with physiological,inflammatory and infective measures in COPD[J].Respir Res,2018,19(1):31.
[15]张凯,张玲玉,张成琪,等.CT定量分析COPD患者气流受限的影响因素[J].实用放射学杂志,2017,33(5):758-761.
[16]Karayama M,Inui N,Mori K,et al.Respiratory impedance is correlated with morphological changes in the lungs on three-dimensional CT in patients with COPD[J].Sci Rep,2017(7):41709.
[17]Onoe R,Yamashiro T,Handa H,et al.3D-measurement of tracheobronchial angles on inspiratory and expiratory chest CT in COPD:Respiratory changes and correlation with airflow limitation[J].Int J Chron Obstruct Pulmon Dis,2018(13):2399-2407.
[18]Lee SM,Seo JB,Lee SM,et al.Optimal threshold of subtraction method for quantification of air-trapping on coregistered CT in COPD patients[J].Eur Radiol,2016,26(7):2184-2192.
[19]张保朋,王道清,程留慧.慢阻肺气肿患者肺通气功能的CT评价[J].中国CT和MRI杂志,2017,15(8):59-61.
[20]Kim EY,Seo JB,Lee HJ,et al.Detailed analysis of the density change on chest CT of COPD using non-rigid registration of inspiration/expiration CT scans[J].Eur Radiol,2015,25(2):541-549.
[21]史维雅,杭晶卿,张志勇,等.呼吸气双相HRCT成像对不同COPD表型的定量评估[J].中国临床医学影像杂志,2018,29(5):329-332.
[22]王文尚.CT肺小血管与肺截面积比值与COPD患者肺功能指标的相关性分析[J].中国CT和MRI杂志,2017,15(7):54-57.
[23]Takayanagi S,Kawata N,Tada Y,et al.Longitudinal changes in structural abnormalities using MDCT in COPD:Do the CT measurements of airway wall thickness and small pulmonary vessels change in parallel with emphysematous progression?[J].Int JChron Obstruct Pulmon Dis,2017(12):551-560.
[24]Coste F,Dournes G,Dromer C,et al.CT evaluation of small pulmonary vessels area in patients with COPD with severe pulmonary hypertension[J].Thorax,2016,71(9):830-837.
[25]汪黎明,宋迪.低剂量螺旋CT扫描对慢性阻塞性肺疾病诊断准确性研究[J].实用放射学杂志,2018,34(4):613-616.
[26]吴俊,李振生,冯光,等.低剂量呼气相胸部CT容积参数与肺功能小气道指标相关性[J].实用医学影像杂志,2018,19(2):93-96.
[27]周洁,刘斯润,曾庆思,等.低剂量HRCT对COPD患者小气道的定量研究[J].临床放射学杂志,2017,36(1):55-60.
[28]夏亭亭,赖政道,尤晓婷,等.低剂量CT扫描对COPD及哮喘患者近端气道重塑的对比研究[J].临床放射学杂志,2017,36(1):49-53.
[29]Chen H,Chen GQ,Zeng QS,et al.Quantitative assessment of airway pathology in subjects with copd using low-dose high-resolution computed tomography[J].Respir Care,2017,62(7):953-962.
[30]陈一鸣,刘阳,任何,等.多层螺旋CT低剂量扫描对慢性阻塞性肺疾病患者复查的诊断价值[J].实用放射学杂志,2016,32(9):1437-1439.
[31]Yamashiro T,Moriya H,Matsuoka S,et al.Asynchrony in respiratory movements between the pulmonary lobes in patients with COPD:Continuous measurement of lung density by 4-dimensional dynamic-ventilation CT[J].Int J Chron Obstruct Pulmon Dis,2017(12):2101-2109.
[32]Hightower JS,Amadi C,Den E,et al.Back to the future:Sagittal CT in the evaluation of COPD[J].Eur Radiol,2016,26(8):2730-2739.
[2]Lozano R,Naghavi M,Foreman K,et al.Global and regional mortality from 235 causes of death for 20 age groups in 1990 and2010:A systematic analysis for the global burden of disease study2010[J].Lancet,2012,380(9859):2095-2128.
[3]Montes de Oca M,Pérez-Padilla R.Global initiative for chronic obstructive lung disease(gold)-2017:The alat perspective[J].Arch Bronconeumol,2017,53(3):87-88.
[4]Cho YH,Seo JB,Kim N,et al.Comparison of a new integralbased half-band method for CT measurement of peripheral airways in copd with a conventional full-width half-maximum method using both phantom and clinical CT images[J].J Comput Assist Tomogr,2015,39(3):428-436.
[5]Lynch DA,Austin JH,Hogg JC,et al.CT-definable subtypes of chronic obstructive pulmonary disease:A statement of the fleischner society[J].Radiology,2015,277(1):192-205.
[6]高永炳,龚波,武洪林,等.慢性阻塞性肺疾病肺通气功能与CT肺气肿指数的研究[J].医学影像学杂志,2016,26(12):2224-2227.
[7]Saure EW,Bakke PS,Lind Eagan TM,et al.Diffusion capacity and CT measures of emphysema and airway wall thickness-relation to arterial oxygen tension in COPD patients[J].Eur Clin Respir J,2016(3):29141.
[8]张迪,管宇,范丽,等.吸烟者多层螺旋CT双呼吸相肺气肿、空气潴留定量及与肺功能的相关性分析[J].中华医学杂志,2018,98(19):1467-1473.
[9]Shaikh M,Sood RG,Sarkar M,et al.Quantitative computed tomography(CT)assessment of emphysema in patients with severe chronic obstructive pulmonary disease(copd)and its correlation with age,sex,pulmonary function tests,BMI,smoking,and biomass exposure[J].Pol J Radiol,2017(82):760-766.
[10]Müller J,Lim HJ,Eichinger M,et al.Influence of fissure integrity on quantitative CT and emphysema distribution in emphysematype copd using a dedicated copd software[J].Eur J Radiol,2017(95):293-299.
[11]阎超群,张攀,史达,等.基于高分辨率CT对慢性阻塞性肺疾病的定量测量与临床肺功能对照研究[J].实用医学杂志,2016,32(8):1258-1261.
[12]杨飞,纪蒙蒙,朱晓龙,等.右肺上叶尖段及其亚段支气管CT定量参数对慢性阻塞性肺疾病病情的评估价值[J].山东医药,2018,58(12):14-17.
[13]Nambu A,Zach J,Schroeder J,et al.Quantitative computed tomography measurements to evaluate airway disease in chronic obstructive pulmonary disease:Relationship to physiological measurements,clinical index and visual assessment of airway disease[J].Eur JRadiol,2016,85(11):2144-2151.
[14]Ostridge K,Williams NP,Kim V,et al.Relationship of CT-quantified emphysema,small airways disease and bronchial wall dimensions with physiological,inflammatory and infective measures in COPD[J].Respir Res,2018,19(1):31.
[15]张凯,张玲玉,张成琪,等.CT定量分析COPD患者气流受限的影响因素[J].实用放射学杂志,2017,33(5):758-761.
[16]Karayama M,Inui N,Mori K,et al.Respiratory impedance is correlated with morphological changes in the lungs on three-dimensional CT in patients with COPD[J].Sci Rep,2017(7):41709.
[17]Onoe R,Yamashiro T,Handa H,et al.3D-measurement of tracheobronchial angles on inspiratory and expiratory chest CT in COPD:Respiratory changes and correlation with airflow limitation[J].Int J Chron Obstruct Pulmon Dis,2018(13):2399-2407.
[18]Lee SM,Seo JB,Lee SM,et al.Optimal threshold of subtraction method for quantification of air-trapping on coregistered CT in COPD patients[J].Eur Radiol,2016,26(7):2184-2192.
[19]张保朋,王道清,程留慧.慢阻肺气肿患者肺通气功能的CT评价[J].中国CT和MRI杂志,2017,15(8):59-61.
[20]Kim EY,Seo JB,Lee HJ,et al.Detailed analysis of the density change on chest CT of COPD using non-rigid registration of inspiration/expiration CT scans[J].Eur Radiol,2015,25(2):541-549.
[21]史维雅,杭晶卿,张志勇,等.呼吸气双相HRCT成像对不同COPD表型的定量评估[J].中国临床医学影像杂志,2018,29(5):329-332.
[22]王文尚.CT肺小血管与肺截面积比值与COPD患者肺功能指标的相关性分析[J].中国CT和MRI杂志,2017,15(7):54-57.
[23]Takayanagi S,Kawata N,Tada Y,et al.Longitudinal changes in structural abnormalities using MDCT in COPD:Do the CT measurements of airway wall thickness and small pulmonary vessels change in parallel with emphysematous progression?[J].Int JChron Obstruct Pulmon Dis,2017(12):551-560.
[24]Coste F,Dournes G,Dromer C,et al.CT evaluation of small pulmonary vessels area in patients with COPD with severe pulmonary hypertension[J].Thorax,2016,71(9):830-837.
[25]汪黎明,宋迪.低剂量螺旋CT扫描对慢性阻塞性肺疾病诊断准确性研究[J].实用放射学杂志,2018,34(4):613-616.
[26]吴俊,李振生,冯光,等.低剂量呼气相胸部CT容积参数与肺功能小气道指标相关性[J].实用医学影像杂志,2018,19(2):93-96.
[27]周洁,刘斯润,曾庆思,等.低剂量HRCT对COPD患者小气道的定量研究[J].临床放射学杂志,2017,36(1):55-60.
[28]夏亭亭,赖政道,尤晓婷,等.低剂量CT扫描对COPD及哮喘患者近端气道重塑的对比研究[J].临床放射学杂志,2017,36(1):49-53.
[29]Chen H,Chen GQ,Zeng QS,et al.Quantitative assessment of airway pathology in subjects with copd using low-dose high-resolution computed tomography[J].Respir Care,2017,62(7):953-962.
[30]陈一鸣,刘阳,任何,等.多层螺旋CT低剂量扫描对慢性阻塞性肺疾病患者复查的诊断价值[J].实用放射学杂志,2016,32(9):1437-1439.
[31]Yamashiro T,Moriya H,Matsuoka S,et al.Asynchrony in respiratory movements between the pulmonary lobes in patients with COPD:Continuous measurement of lung density by 4-dimensional dynamic-ventilation CT[J].Int J Chron Obstruct Pulmon Dis,2017(12):2101-2109.
[32]Hightower JS,Amadi C,Den E,et al.Back to the future:Sagittal CT in the evaluation of COPD[J].Eur Radiol,2016,26(8):2730-2739.