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目的探讨64排CT定量测量段支气管为COPD患者的诊断及分级提供依据的可行性,研究COPD患者肺气肿区域与肺功能的关系。方法收集60例临床确诊为COPD患者,1周内行64层螺旋CT扫描和肺功能检查,利用MRP技术在右肺上叶尖段、左肺上叶尖后段、右肺下叶后基底段、左肺下叶后基底段段支气管垂直层面重建其断面图像,测量并计算各段支气管腔及截面面积及半径,计算支气管腔面积与截面积比(AI/AO)、管壁厚度与截面半径比(TDR)与肺功能检查(PFT)指标的关系。结果段支气管测量数据与PFT指标具有相关性;且各段支气管相关性以右肺下叶最佳。结论段支气管定量测量可反映COPD患者的肺功能减低程度;COPD患者病变位于右肺下叶对肺功能影响最大;CT对段支气管定量测量可弥补肺功能对COPD诊断的不足。
Objective To investigate the feasibility of providing a basis for the diagnosis and classification of bronchial carcinoma in patients with COPD by 64-slice CT quantitative measurement and to study the relationship between pulmonary emphysema and pulmonary function in COPD patients. Methods Sixty patients with clinically diagnosed COPD were enrolled in this study. 64-slice spiral CT and pulmonary function tests were performed within one week. MRP was used to detect the presence of COPD in the apical segments of the right lung, posterior segments of the left lung and posterior segments of the right lower lobe, The left lower lobe of the posterior segment of the basal segment of the bronchial vertical reconstruction of the cross-sectional images, measurement and calculation of bronchial lumen and cross-sectional area and radius of each section, the calculation of bronchus cavity area to cross-sectional area ratio (AI / AO), wall thickness and cross section radius ratio TDR) and pulmonary function test (PFT) indicators. The results of bronchial section of the data and PFT indicators are relevant; and the bronchial relevance of each segment of the right lower lobe of the best. Conclusion Quantitative measurement of segmental bronchus can reflect the degree of pulmonary function decline in patients with COPD. The lesion in COPD patients has the greatest impact on pulmonary function in the lower right lobe of lung. Quantitative measurement of bronchus by segment CT can make up for the deficiency of lung function in the diagnosis of COPD.