HRCT对肺气肿双项扫描研究探究.doc

HRCT对肺气肿双项扫描研究探究【摘要】目的：评价肺气肿在HRCT双项扫描时的表现。方法：对临床和肺功能检查确诊的肺气肿病人40例与正常对照组20例，用HRCT分别进行深呼气末和深吸气末的CT扫描，测其CT值。所获数据用t检验。结果：肺气肿组在深吸气末的CT值与正常组相近，但在深呼吸末则明显低于正常组。其差异：正常组呼吸气之间平均为193Hu，肺气肿的差值为20.3Hu。结论：HRCT在诊断肺气肿时，呼气末要比吸气末更准确。 【关键词】肺气肿；体层摄影术；X线计算机 文章编号：1009-5519（2008）05-0646-02 中图分类号：R81 文献标识码：A Research of emphysema by HRCT XU Xia-yin (Heze Municipal Hospital Affiliated to Heze College，Heze 274031，China) 【Abstract】Objective：To evaluate the feature of emphysema in HRCT at the end of inspiration and expiration.Methods：Forty pulmonary emphysema patients (The diagnosis of pulmonary emphysema was made by a combination of clinical and pulmonary function tests)were scanned by HRCT at the and of inspiration and expiration，for comparison with 20 control subjects with mormal PET results and without respiratory disorder were selected for the present study.Results：The CT value of emphysema and control subjects at end of inspiration was 902.2±22.7 HU and 888.4±39 HU respectively，but at endofexpiration，the emphysema group was evidently lower than control group.The difference between the end of inspiration and the end of expiration in control group and emphysema group was 193 Hu and 20.3HU respectively.Conclusion：The diagnosis of pulmonary emphysema by HRCT is better at the end of expiration than inspiration. 【Key words】Emphysema；Tomography；X-ray computer 肺气肿在病理的定义是终末细支气管以远气腔的持久性异常扩张伴有壁的破坏而无明显的肺纤维化。肺气肿的诊断主要依靠临床、胸片和肺功能，而胸片对轻、中度肺气肿极不敏感。近年来高分辨率CT（HRCT）对肺气肿的诊断发挥着越来越重要的作用[1]，特别是呼气末的HRCT扫描越来越受到重视。我们对肺气肿深呼吸不同时限CT值进行检测，现将结果报道如下。 1 资料与方法 1.1 一般资料：（1）肺气肿组：肺功能检查和临床同时诊断为肺气肿的病人40例，男35例，女5例。年龄40～80岁，平均61.2岁。所选择的病人符合以下条件：①无肺心病及其他器质性心脏病。②无胸部手术史及其他限制呼吸运动的因素。③无支气管扩张、支气管炎、肺纤维化、肺大泡、肺不张及肺肿瘤等肺部病变。（2）正常组：20例，年龄22～80岁，无吸烟史，CT和肺功能检查均正常。（3）所有受检者均作肺功能检查，检查项目包括：FEV1%、RV、RV/TLC、FRC、TLC。 1.2 HRCT检查：所有受检者均经肺功能检查后2周之内作HRCT检查。所用设备为日立公司生产的TURBO RADIX螺旋CT机，扫描参数为175KV/130NA，时间为1秒，层厚1.5 mm。用骨算法重建图像，矩阵为512×512，窗宽为1400 Hu，窗位-700 HU。受检者取仰卧位，首先于深吸气末屏气做定位像，在主动脉弓、气管隆突及右膈上2 cm水平作层厚1.5 mm的HRCT扫描，这三个层面分别