目的 探讨CT定量分析在抗合成酶综合征合并间质性肺炎(ASS-ILD)中的应用价值。方法 回顾性分析2015-01至2022-06在武警特色医学中心呼吸科收治的ASS-ILD患者临床资料42例。CT影像利用定量软件自动分析,计算出肺总容积(TLV)和平均肺衰减值(MLA),计算出不同区域的体积和重量,以及其占肺总容积的百分比,然后分析CT定量指标与肺功能检查(PFT)参数的相关性,并对ASS-ILD中非特异性间质性肺炎合并机化性肺炎(NSIP/OP)和机化性肺炎(OP)两种类型的CT定量指标进行对比分析。结果 用力肺活量占预计值百分比(FVC%)和第一秒用力呼气容积占预计值百分比(FEV1%)与-500～-100 HU区域CT值呈正相关(r＝0.58,P＝0.048;r＝0.79,P＝0.01),FEV1/FVC与-950～-500区域CT值呈负相关(r＝-0.23,P＝0.01),均具有统计学意义(P＜0.05)。 NSIP/OP组不良通气体积(Vfibrosis%)高于OP组(P＝0.03),一氧化碳弥散量(DLCO%)明显低于OP组(P＝0.01);OP组的过度通气体积(Vhyper%)和过度通气重量(Whyper%)较NSIP/OP组高(P＜0.05);NSIP/OP组总肺平均衰竭值(MLAtotal)明显高于OP组(P＜0.01)。结论 HRCT定量分析指标与PFT参数有较好的相关性,可用于肺功能的评估,并对NSIP/OP和OP的类型判定有参考价值。
Abstract
Objective To explore the application value of CT quantitative analysis in antisynthetase syndrome complicated with interstitial pneumonia(ASS-ILD).Methods The clinical data of 42 patients with ASS-ILD admitted to the respiratory department of Characteristics Medical Center of Chinese People's Armed Police Force from January 2015 to June 2022 were retrospectively analyzed. Quantitative software was used to automatically analyze CT images to the total lung volume (TLV) and mean lung attenuation (MLA), caculate the volume and weight of different regions and their percentage in the total lung volume, and then analyze the correlation between CT quantitative indexes and PFT parameters. CT quantitative indexes of nonspecific interstitial pneumonia with organizing pneumonia (NSIP/OP) and organizing pneumonia (OP) were compared and analyzed.Results FVC% and FEV1% were positively correlated with -500 HU to -100HU area (r＝0.58, P＝0.048; r＝0.79, P＝0.01), FEV1/FVC was negatively correlated with -950 HU to -500 area (r＝-0.23, P＝0.01), with statistical significance (P<0.05). The bad ventilation volume (Vfibrosis%) in the NSIP/OP group was significantly higher than that in the OP group (P＝0.03), and the carbon monoxide diffusion capacity (DLCO%) was significantly lower than that in the OP group (P＝0.01). The volume of hyperventilation (Vhyper%) and weight of hyperventilation (Whyper%) in the OP group were higher than those in the NSIP/OP group (P<0.05). The total lung average failure value (MLAtotal) in the NSIP/OP group was significantly higher than that in the OP group (P<0.01).Conclusions There is a good correlation between HRCT quantitative analysis and PFT parameters, which can be used to evaluate lung function, and has reference value for NSIP/OP and OP type determination.
关键词
抗合成酶综合征 /
高分辨率CT /
定量分析 /
非特异性间质性肺炎 /
机化性肺炎
Key words
antisynthetase syndrome /
high resolution CT /
quantitative analysis /
nonspecific interstitial pneumonia /
organizing pneumonia
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