定量CT在评估类风湿性关节炎相关间质性肺病中的应用-《中国医学物理学杂志》

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Title:: Application of quantitative CT in assessing rheumatoid arthritis-associated interstitial lung diseases

文章编号:: 1005-202X（2022）07-0860-05

作者:: 蒲豆豆1; 袁慧2; 马光明3; 段海峰3; 张敏3; 于楠1; 3; 1.陕西中医药大学医学技术学院，陕西咸阳 712046； 2.陕西中医药大学附属医院风湿免疫血液科，陕西咸阳 712000； 3.陕西中医药大学附属医院医学影像科，陕西咸阳 712000

Author(s):: PU Doudou1; YUAN Hui2; MA Guangming3; DUAN Haifeng3; ZHANG Min3; YU Nan1; 3; 1. School of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang 712046, China 2. Department of Rheumatology Immunohematology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China 3. Department of Medical Imaging, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China

关键词:: 类风湿关节炎; 间质性肺病; 体层摄影术; 定量分析

Keywords:: Keywords: rheumatoid arthritis interstitial lung disease computed tomography quantitative analysis

分类号:: R816.4

DOI:: DOI:10.3969/j.issn.1005-202X.2022.07.012

文献标志码:: A

摘要:: 目的：探究胸部CT定量分析对于类风湿性关节炎相关间质性肺病（RA-ILD）患者肺间质改变早期诊断及病情评估的价值。方法：收集临床确诊RA患者105例，同时收集胸部CT无间质改变的非结缔组织病患者对照组80例。测量两组研究对象肺总体积（TLV），利用定量CT肺部密度直方图计算CT值为-200~-700 HU的肺体积占全肺体积百分比（LAA-200~-700%）、CT值小于-950 HU的肺体积占全肺体积百分比（LAA-950%）、主动脉直径（AD）、肺动脉干直径（PAD）、主肺动脉干比值（AD/PAD）、左肺下叶直径2 mm支气管周围血管数量及面积（视区范围80 mm2）。比较RA患者组与对照组的测量值差异。结果：RA患者组与对照组相比，TLV、LAA-200~-700%、PAD、左肺下叶直径为2 mm的支气管视区范围为80 mm2时肺血管数量及面积均存在差异，其中RA患者组TLV为（4 047.60±1 160.11） mL，小于对照组（4 507.30±1 207.50） mL；LAA-200~-700%为14.42%±8.62%，大于对照组10.40%±3.87%，PAD为（26.39±3.59） mm，大于对照组（25.27±2.57） mm；RA组左肺下叶直径为2 mm支气管层面视区范围为80 mm2时肺血管数量为13.3±6.28，面积为（105.48±59.07） mm2；对照组血管数量为17.06±4.70，血管面积为（164.88±46.02） mm2，差异有统计学意义（P<0.001）。结论：RA-ILD患者肺部与对照组相比有差异，定量CT能有效识别评估RA-ILD早期肺血管改变。

Abstract:: Abstract: Objective To explore the value of quantitative CT in the early diagnosis and assessment of pulmonary vascular changes in patients with rheumatoid arthritis-associated interstitial lung diseases (RA-ILD). Methods A total of 105 patients clinically diagnosed with RA and 80 controls with no connective tissue diseases and no interstitial changes in chest CT were enrolled in the study. The total?ung volume (TLV), the percentage of lung volume with CT number from -200 HU to -700 HU in the total lung volume (LAA-200~-700%), the percentage of lung volume with CT number less than -950 HU in total lung volume(LAA-950%), the diameters of aorta (AD) and pulmonary artery (PAD), the ratio of AD to PAD (AD/PAD), the number and area of blood vessels around the bronchus with a diameter of 2 mm in the lower lobe of the left lung (with a visual area of 80 mm2) were measured in the two groups. The differences of the measured values between RA patients and controls were compared. Results There were differences between RA group and control group in TLV, LAA-200~-700%, PAD and the number and area of blood vessels around the bronchus with a diameter of 2 mm in the lower lobe of the left lung (with a visual area of 80 mm2). The TLV in RA group was (4 047.60±1 160.11) mL, smaller than (4 507.30±1 207.50) mL in control group and the LAA-200~-700% and PAD in RA group were higher or larger than those in control group ［14.42%±8.62% vs 10.40%±3.87% (26.39±3.59) mm vs (25.27±2.57) mm］. When the visual area was 80 mm2,?he number and area of pulmonary vessels around the bronchus with a diameter of 2 mm in the lower lobe of the left lung were 13.3±6.28 and (105.48±59.07) mm2?n RA group, obviously less than those in control group which were 17.06±4.70 and (164.88±46.02) mm2 (P<0.001). Conclusion The lung of patients with RA-ILD is different from that of healthy controls. Quantitative CT can effectively identify and assess the pulmonary vascular changes in the early stage of RA-ILD.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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