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目的评价螺旋CT肺密度测定在诊断肺气肿中的应用价值。方法对CT诊断的130例不同病理类型肺气肿和80例正常肺,采用16层螺旋CT附带的Pulmo自动评价软件进行肺密度测量。以肺尖、肺门、横膈3个区的平均CT值作为平均肺密度(ALD)。评价正常组与肺气肿组,以及各类肺气肿的平均肺密度差异有无显著性。结果105例肺气肿(105/130)平均肺密度有不同程度的降低,全小叶型肺气肿密度降低最为明显,其它类型肺气肿肺CT值降低幅度减少。15例小叶中央型肺气肿和10例单纯型肺大泡平均肺密度值正常。各类肺气肿的正常肺密度例数与异常肺密度的例数比较有统计学意义(χ2=50.275,P<0.001)。71例正常肺(71/80)肺密度正常,9例异常。肺气肿组与正常组的平均肺密度差别有统计学意义(χ2=49.884,P值<0.001)。结论螺旋CT肺密度测定能准确评价不同类型肺气肿的肺密度,并能按肺密度推测肺气肿类型。对肺气肿的定性、定位及分型诊断具有较高价值。
Objective To evaluate the value of spiral CT in the diagnosis of emphysema. Methods 130 cases of pulmonary emphysema and 80 cases of normal lung were diagnosed by CT. Pulm density was measured by 16-slice spiral CT with Pulmo automatic evaluation software. The average CT value of lung apex, hilar and diaphragm were calculated as the average lung density (ALD). Evaluation of normal group and emphysema group, as well as various types of emphysema average lung density difference was significant. Results The average lung density in 105 cases of emphysema (105/130) decreased to some extent, the density of emphysema in whole leaflet decreased most obviously, and the reduction of CT value in other types of emphysema decreased. 15 cases of lobular central emphysema and 10 cases of simple bullae average lung density was normal. The number of cases of various types of emphysema between normal lung density and abnormal lung density was statistically significant (χ2 = 50.275, P <0.001). 71 normal lungs (71/80) had normal lung density and 9 abnormalities. The average lung density in emphysema group was significantly different from that in normal group (χ2 = 49.884, P <0.001). Conclusion Spiral CT pulmonary density can accurately evaluate the lung density of different types of emphysema and speculate the type of emphysema according to the lung density. Emphysema on the qualitative, localization and classification of diagnosis has high value.