MDCT扫描精确评估气胸压缩比
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摘要
目的探讨MDCT精确评估气胸压缩比的价值。方法回顾性分析92例气胸患者的胸部MDCT资料,测量气胸压缩肺容积和胸廓容积,计算气胸压缩比;在胸廓腋中线层面冠状面测量胸廓肺尖至膈顶的上下径(H),于肺上叶支气管下壁层面测量胸廓的左右径(W)和前后径(D),于相同层面测量气胸压缩肺的上下径(h)、左右径(w)和前后径(d),计算其比值(hwd/HWD),分别获得左右两肺气胸压缩比(Y)与hwd/HWD(X)的线性回归方程。结果左肺的线性回归方程为Y=0.951-0.864 X(r=-0.961,R2=0.922,P<0.001);右肺的线性回归方程为Y=0.936-0.808 X(r=-0.966,R2=0.932,P<0.001)。经上述回归方程计算的压缩比与CT测量压缩比差异均无统计学意义(P均>0.05)。结论在MDCT图像上对气胸压缩肺和胸廓各径线进行测量,并经过简单计算,即可精确评估气胸压缩比,为临床选择治疗方案提供参考。
Objective To explore the value of MDCT in accurate evaluation of compression ratio of pneumothorax.Methods MDCT data of 92 patients with pneumothorax were retrospectively analyzed.The volume of compressed and normal chest was measured with MDCT,and the compression ratio was calculated.The longitudinal diameter(H)of the chest was measured from thoracic apex to diaphragm in the coronal view of midaxillary line,and the chest width(W)and diameter(D)were measured at the level of the superior lobar bronchus.In the same way,the longitudinal diameter(h),width(w)and diameter(d)of the pneumothorax lung were obtained simultaneously,and the ratio of hwd/HWD was calculated.The linear regression equation was analyzed between the compression ratio(Y)and hwd/HWD(X)at both right and left lung,respectively.Results The correlation regression equation of left lung was Y=0.951-0.864 X(r=-0.961,R2=0.922,P<0.001),of right lung was Y=0.936-0.808 X(r=-0.966,R2=0.932,P<0.001).There was no significant difference of compression ratio obtained with correlation regression equations and MDCT(both P>0.05).Conclusion The compression ratio of pneumothorax can be accurately evaluated with measuring the diameters of compressed lung and chest in MDCT,therefore providing references for clinical treatment.
Objective To explore the value of MDCT in accurate evaluation of compression ratio of pneumothorax.Methods MDCT data of 92 patients with pneumothorax were retrospectively analyzed.The volume of compressed and normal chest was measured with MDCT,and the compression ratio was calculated.The longitudinal diameter(H)of the chest was measured from thoracic apex to diaphragm in the coronal view of midaxillary line,and the chest width(W)and diameter(D)were measured at the level of the superior lobar bronchus.In the same way,the longitudinal diameter(h),width(w)and diameter(d)of the pneumothorax lung were obtained simultaneously,and the ratio of hwd/HWD was calculated.The linear regression equation was analyzed between the compression ratio(Y)and hwd/HWD(X)at both right and left lung,respectively.Results The correlation regression equation of left lung was Y=0.951-0.864 X(r=-0.961,R2=0.922,P<0.001),of right lung was Y=0.936-0.808 X(r=-0.966,R2=0.932,P<0.001).There was no significant difference of compression ratio obtained with correlation regression equations and MDCT(both P>0.05).Conclusion The compression ratio of pneumothorax can be accurately evaluated with measuring the diameters of compressed lung and chest in MDCT,therefore providing references for clinical treatment.
引文
[1]乔贵宾,陈刚.自发性气胸的处理:广东胸外科行业共识(2016年版).中国胸心血管外科临床杂志,2017,24(1):6-15.
[2]Cai W,Lee JG,Fikry K,et al.MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax.Comput Med Imaging Graph,2012,36(5):375-386.
[3]周志尊,崔豹,丁晶,等.活体器官不规则体积计算方法的研究.中国医学物理学杂志,2011,28(4):2754-2758.
[4]魏仁国,谭利华.肺压缩容积影像学测量方法.医学综述,2011,17(23):3639-3641.
[5]薛城敬.气胸患者肺压缩率的评估方法及应用此方法的体会.医学综述,2011,9(9):68.
[6]杨斐,胡海平,许小兰,等.MDCT Tissue Segmentation技术测定气胸、液气胸中肺压缩比率方法研究.医学影像学杂志,2016,26(9):1602-1605.
[7]陈永权,陈莉,吕发金.游离气胸的多层螺旋CT定量研究.中国医学影像学杂志,2016,24(10):750-754.
[8]梁树生,周国永,郑华英,等.气胸肺压缩比的CT测量研究.临床放射学杂志,2017,36(1):60-63.
[9]邓承,苏云杉,向述天.气胸容积CT快速量化测定研究.临床放射学杂志,2017,36(8):1116-1120.
[10]王军岐,仝瑞锋,付小伟,等.首次发作原发自发性气胸的治疗方案探讨.中华腔镜外科杂志(电子版),2014,7(5):372-375.
[11]于学军.气胸的临床治疗体会.临床医药文献杂志,2016,3(30):5970.
[12]李永军,赵刚,彭芬加.自发性气胸初始治疗方案的选择.总装备部医学学报,2015,17(2):104-105.
[13]Do S,Salvaggio K,Gupta S,et al.Automated quantification of pneumothorax in CT.Comput Math Methods Med,2012,2012:736320.
[2]Cai W,Lee JG,Fikry K,et al.MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax.Comput Med Imaging Graph,2012,36(5):375-386.
[3]周志尊,崔豹,丁晶,等.活体器官不规则体积计算方法的研究.中国医学物理学杂志,2011,28(4):2754-2758.
[4]魏仁国,谭利华.肺压缩容积影像学测量方法.医学综述,2011,17(23):3639-3641.
[5]薛城敬.气胸患者肺压缩率的评估方法及应用此方法的体会.医学综述,2011,9(9):68.
[6]杨斐,胡海平,许小兰,等.MDCT Tissue Segmentation技术测定气胸、液气胸中肺压缩比率方法研究.医学影像学杂志,2016,26(9):1602-1605.
[7]陈永权,陈莉,吕发金.游离气胸的多层螺旋CT定量研究.中国医学影像学杂志,2016,24(10):750-754.
[8]梁树生,周国永,郑华英,等.气胸肺压缩比的CT测量研究.临床放射学杂志,2017,36(1):60-63.
[9]邓承,苏云杉,向述天.气胸容积CT快速量化测定研究.临床放射学杂志,2017,36(8):1116-1120.
[10]王军岐,仝瑞锋,付小伟,等.首次发作原发自发性气胸的治疗方案探讨.中华腔镜外科杂志(电子版),2014,7(5):372-375.
[11]于学军.气胸的临床治疗体会.临床医药文献杂志,2016,3(30):5970.
[12]李永军,赵刚,彭芬加.自发性气胸初始治疗方案的选择.总装备部医学学报,2015,17(2):104-105.
[13]Do S,Salvaggio K,Gupta S,et al.Automated quantification of pneumothorax in CT.Comput Math Methods Med,2012,2012:736320.