摘要
目的:结合视觉评分及定量CT指标对患者肺纤维化严重程度进行风险分层。方法:纳入96例结缔组织疾病相关间质性肺病(CTD-ILD)患者和47例无间质性肺疾病(ILD)的结缔组织病(CTD)对照组,采用Warrick评分和3D Slicer密度直方图法评估肺纤维化程度。结果:标准差(SD)、峰度(Kurtosis)、偏度(Skewness)在不同严重程度组间存在显著差异。多因素逻辑回归显示,高衰减区(HAA%)是患者肺纤维化程度的独立预测指标。受试者操作特征曲线(ROC)表明,联合所有定量CT参数区分正常轻度与中重度患者曲线下面积(AUC)为0.846(灵敏度0.739,特异度0.885)。相关性分析显示,Perc10、Perc15、MLA与RV/TLC存在较弱的正相关。结论:该方法可无创、客观评估CTD-ILD严重程度,为肺功能检测受限患者提供有效替代方案,降低诊疗成本,适合基层推广。
Objective:To classify pulmonary fibrosis severity in connective tissue disease-associated interstitial lung disease(CTD-ILD)patients by integrating visual scoring and quantitative computed tomography(CT).Methods:A total of 96 patients with CTD-ILD and 47 CTD controls without ILD were enrolled.Pulmonary fibrosis was evaluated using the Warrick score and the 3D slicer-based density histogram method.Results:Significant differences were observed in standard deviation(SD),kurtosis,and skewness across the severity groups.Multivariate logistic regression analysis identified HAA as an independent predictor of fibrosis severity.The receiver-operating characterisric curve(ROC)showed that combining all quantitative CT parameters achieved an area under the curve(AUC)of 0.846(sensitivity=0.739 and specificity=0.885)to distinguish normal/mild cases from moderate/severe cases.Weak positive correlations were observed between Perc10,Perc15,MLA,and RV/TLC.Conclusion:This approach enables a noninvasive and objective assessment of CTD-ILD severity,thereby providing a clinically valuable alternative for patients with limitations in pulmonary function testing,reducing diagnostic and therapeutic costs,and demonstrating a strong potential for widespread implementation in primary healthcare settings.
作者
王珂
胡子涛
崔露露
郭声雅
黄晓旗
WANG Ke;HU Zitao;CUI Lulu;GUO Shengya;HUANG Xiaoqi(Radiology Department,Affiliated Hospital of Yan’an University,Yan’an 716000,China)
出处
《CT理论与应用研究(中英文)》
2025年第4期589-597,共9页
Computerized Tomography Theory and Applications
基金
陕西省科技厅重点研发计划(基于体素对吸烟者肺结构损伤的定量研究(2021SF-254))
延安大学教育创新项目(基于定量CT评估类风湿关节炎相关间质性肺疾病(YCX2024116))。
