目的 探讨高原肺水肿(HAPE)引起肺部改变的CT定量参数变化。方法 回顾性分析2021-12至2023-12新疆塔什库尔干塔吉克自治县人民医院收治的20例HAPE患者影像学资料,对治疗前后胸部CT图像进行定量分析。CT定量评价指标包括左肺病变体积(LVLL)、右肺病变体积(LVRL)、病变总体积(TLV)、病变占总肺体积百分比(TLV/TL%)。比较HAPE患者治疗前后CT定量指标的差异,分析治疗前CT定量指标与血氧饱和度(SpO2)和住院时间的相关性。结果 20例HAPE共进行40次胸部CT扫描,平均间隔时间为(3.2±0.7)d。HAPE患者治疗前LVRL显著大于LVLL[(1267±484 )cm3 vs. (888±544) cm3,P<0.05];治疗后TLV显著低于治疗前[(445±490) cm3 vs. (2156±802) cm3,P<0.001],治疗后TLV/TL%显著低于治疗前(13%±13% vs. 49%±17%,P<0.001)。治疗前LVLL、TLV、TLV/TL%与SpO2呈负相关(r=－0.493,P<0.05;r=－0.567,P<0.01;r=－0.832,P<0.001),治疗前TLV/TL%与住院日呈正相关(r=0.553,P<0.05),SpO2与住院日呈负相关(r=－0.486,P<0.05)。结论 HAPE患者的右肺损伤较左肺严重,CT定量参数是评价HAPE病情严重程度和治疗效果的有效指标。
Abstract
Objective To investigate the changes of quantitative CT parameters of lung changes caused by high altitude pulmonary edema (HAPE), and to provide quantitative imaging basis for the evaluation of the treatment effect of HAPE patients. Methods A retrospective analysis was conducted on the imaging data of 20 patients with HAPE admitted to the Taxkorgan County People’s Hospital of Xinjiang autonomous region from December 2021 to December 2023. The initial and follow-up chest CT images were analyzed quantitatively. The quantitative CT indices included lesion volume of left lung (LVLL), lesion volume of right lung (LVRL), total lesion volume (TLV), and the percentage of lesion volume in total lung volume (TLV/TL%). The differences in quantitative CT indices before and after treatment in HAPE patients were compared. The correlation between pre-treatment CT indices and blood oxygen saturation (SpO2) and length of hospital stay were analyzed. Results A total of 40 chest CT scans were conducted in 20 patients with confirmed HAPE, and the average interval was (3.2±0.7) days. Before treatment, the LVRL was significantly higher than the LVLL in the HAPE patients [(1267±484)cm3 vs. (888±544)cm3, P<0.05]. The TLV after treatment were significantly lower than that before treatment [(445±490)cm3 vs. (2156±802)cm3, P<0.001]. The TLV/TL% after treatment were significantly lower than that before treatment (13%±13% vs. 49%±17%, P<0.001). The LVLL, TLV, and TLV/TL% before treatment were negatively correlated with SpO2 (r=-0.493, P<0.05; r=-0.567, P<0.01; r=-0.832, P<0.001). The TLV/TL% before treatment were positively correlated with hospitalization day (r=0.553, P<0.05). The SpO2 was negatively correlated with hospitalization day (r=-0.486,P<0.05). Conclusions The injury of right lung in HAPE patients is more serious than that of left lung. Quantitative CT parameter is an effective index to evaluate the severity of HAPE and the treatment effect.
关键词
高原肺水肿 /
定量CT /
计算机体层成像
Key words
high altitude pulmonary edema /
quantitative CT /
computerized tomography
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