多层螺旋CT像素指数定量分析在新型冠状病毒肺炎评估中的应用价值研究

doi:10.19871/j.cnki.xfcrbzz.2021.01.005

摘要/Abstract

摘要： 目的探讨多层螺旋CT（MSCT）像素指数（PI）的定量分析在新型冠状病毒肺炎首次CT及病程评估中的临床应用价值。方法回顾性收集2020年1月22日至2020年3月1日惠州市中心人民医院确诊的48例新型冠状病毒肺炎患者胸部MSCT数据,使用肺功能Thoracic VCAR软件分割肺叶,测量PI<-700Hu、-700~-300Hu、>-300Hu值,分析首次CT检查肺叶PI特点及发病后不同时期阶段（第1周、第2周、第3周、第4周及以上）PI的变化规律。结果 ①PI<-700Hu、-700~-300Hu、>-300Hu肺叶组间比较差异具有统计学意义（P<0.05）;②各肺叶组内两两比较：右肺中叶PI>-300Hu大于右肺上叶（P<0.05）,双肺下叶PI-700~-300Hu、PI>-300Hu均大于双肺上叶、右肺中叶,双肺下叶PI<-700Hu均小于双肺上叶、右肺中叶（P<0.05）,其余肺叶PI两两比较差异无统计学意义（P>0.05）;③发病后第2周全肺PI-700~-300Hu、PI>-300Hu最高[11.41%(8.66%~19.24%)、2.47%(1.85%~4.36%)],PI<-700Hu最低[86.31%(74.70%~89.54%)]。结论基于MSCT的PI的定量分析可对COVID-19患者肺部渗出、实变进行量化评估,实现肺炎病灶从视觉半定量评估到定量测量转变,可结合常规CT用于COVID-19的病程动态评估。

关键词: 计算机体层成像, 像素指数, 新型冠状病毒肺炎, 定量分析

Abstract: Objective To explore the clinical value of quantitative analysis of multi-slice spiral CT (MSCT) pixel index (PI) in the first CT and disease course assessment of COVID-19. Methods The chest CT date of 48 patients diagnosed with COVID-19 in our hospital from January 22,2020 to March 1,2020 were collected. The Thoracic VCAR software was used for the pulmonary lobes segmentation and PI quantitative evaluation, PI values of pulmonary lope of <-700Hu, -700Hu — -300Hu, >-300Hu were measured. The characteristics of PI in the initial CT examination and the changes of PI among different stages（in 1^st, 2^nd, 3^rd, 4^th and beyond weeks）were analyzed. Results ①The difference of PI<-700Hu, PI-700Hu — -300Hu and PI>-300Hu between the lung lobe groups were found statistically significant (P>0.05). ②Comparison between each lung lobe group: the PI>-300Hu of right middle lobe was higher than that of right upper lobe (P<0.05); PI-700Hu — -300Hu and PI>-300Hu of bilateral lower lobe were higher than those of bilateral upper lobe and lower right middle lobe, PI<-700Hu of bilateral lower lobe were lower than that of bilateral upper lobe and right middle lobe (P<0.05), and the rest of the lung lobe pairwise comparison were not statistically significant(P>0.05). ③PI -700Hu — -300Hu and PI>-300Hu of whole lung were found highest in the second weeks after onset [11.41%(8.66%—19.24%)、2.47%(1.85%—4.36%)], while the PI -1024Hu — -300Hu of the whole lung was fount lowest[86.31%(74.70%—89.54%)]. Conclusion The PI of MSCT CT can quantitatively analyze the pulmonary exudation and consolidation of COVID-19 patients,from visual assessment to accurate quantification. Combined with conventional CT, it can be used for clinical diagnosis and follow-up treatment evaluation of COVID-19 patients.

Key words: Computed tomography, Pixel index, Coronavirus disease 2019, Quantitative analyze

蓝博文, 唐润辉, 张志艳, 陈康胤. 多层螺旋CT像素指数定量分析在新型冠状病毒肺炎评估中的应用价值研究[J]. 新发传染病电子杂志, 2021, 6(1): 22-26.

Lan Bowen, Tang Runhui, Zhang Zhiyan, Chen Kangyin. Research on the application value of MSCT pixel index quantitative analysis in COVID-19 assessment[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(1): 22-26.

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