基于体素观察慢性阻塞性肺疾病肺叶损伤程度及空间分布

目的 探讨基于体素定量CT分析慢性阻塞性肺疾病（COPD）患者肺叶损伤程度及空间分布的价值。方法 在"数字肺"多研究中心连续性纳入接受双气相扫描COPD患者,测定小气道病变（fSAD）和肺气肿（Emph）的定量值;分析患者各肺叶之间Emph、fSAD肺叶损伤程度及肺叶分布的差异,以及各肺叶定量CT分布与肺功能的相关性。结果 最终纳入50例COPD患者。Emph和fSAD均以右肺中叶最重,两肺上叶次之,两肺下叶程度最轻;Emph和fSAD均主要分布于左肺上叶,其次为右肺上叶,右肺中叶分布最少。两肺下叶Emph和fSAD与FEV₁%的相关性较好。结论 COPD患者肺叶损伤程度以右肺中叶及两肺上叶为重,尤其是右肺中叶;Emph和fSAD主要分布于左肺上叶,其次是右肺上叶;两肺下叶损伤对COPD患者肺功能的影响更著。

Injury degree and spatial distribution of pulmonary lobe of chronic obstructive pulmonary disease using voxel-based morphometry

Objective To exlpore the value of voxel-based quantitative CT in evaluation on injury degree and spatial distribution in different lobes of chronic obstructive pulmonary disease (COPD) patients. Methods COPD patients who underwent inspired and expired CT scanning were consecutively recruited from the multi-center study named Digital Lung.Quantitative parametres of functional small-airway disease (fSAD) and emphysema (Emph) were measured. The degree and distribution of pulmonary lobar injury were analyzed according to Emph and fSAD among different pulmonary lobes. At the same time, the correlation of quantitative CT distribution and lung function of each lobe was analyzed. Results A total of 50 COPD patients were eventually included. Emph and fSAD of the right middle lobe (RML) was the most severe, followed by the upper lobes of the two lungs, while the lowest degree of injury were seen in both lower lobes of the lungs. Emph and fSAD were both mainly distributed in the left upper lobe (LUL), followed by in the right upper lobe (RUL), while in the right middle lobe (RML) was the least. Either fSAD or Emph showed better correlations with FEV₁% in both lower lobes. Conclusion The injury of the lobes in COPD patients mainly distribute in the RML and both upper lobes, especially the former. Emph and fSAD mainly distribute in the LUL, followed by the RUL. The lower lobes of the lungs have greater influence on pulmonary function in COPD patients.