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目的应用多层螺旋CT(MSCT)肺密度测定软件,找出肺密度变化与弥漫性结缔组织病(CTD)之间的相关性,探讨其应用价值。方法对222例临床已确诊为CTD的患者和50例体检者,利用MSCT附带的Pulmo自动评估软件测定上、中、下肺区的平均CT值及像素的频率分布(即像素指数)并进行HRCT胸部扫描,依据HRCT是否具有肺间质病变及其程度和肺密度异常增高,经统计学处理,分析肺密度异常与结缔组织病之间的关系。结果222例CTD的病例中,197例平均肺密度有不同程度的增高、像素分布异常和曲线波峰降低并右移,25例患者的平均肺密度和像素分布曲线表现正常,经Spearman等级相关分析和U检验:rs=0.795,U=11.82,P<0.001,结缔组织病和肺密度异常增高之间具有明显的等级相关性。50例体检者中42例平均肺密度和像素分布曲线表现正常,8例平均肺密度有不同程度的异常和像素分布曲线的异常,无相关关系存在。结论平均肺密度和像素分布曲线的异常与CTD致肺间质病变及其程度具有相关性。肺密度异常对早期诊断CTD所致的肺间质病变有一定的应用价值。
Objective To find out the correlation between the changes of lung density and diffuse connective tissue disease (CTD) by using MSCT software, and to explore its application value. Methods Totally 222 patients with clinically diagnosed CTD and 50 healthy subjects were enrolled in this study. The mean CT value and the pixel frequency distribution (ie, pixel index) of the upper, middle and lower lung regions were measured by Pulmo automatic evaluation software attached to MSCT. HRCT According to the chest scan, according to whether HRCT has interstitial lung disease and its extent and abnormality of lung density, the relationship between abnormal lung density and connective tissue disease was analyzed by statistical analysis. Results Among the 222 cases of CTD, the average lung density of 197 patients increased to some extent, the pixel distribution was abnormal and the peak of the curve was decreased and shifted to the right. The average lung density and pixel distribution curve of 25 patients showed normal. According to Spearman rank correlation analysis and U test: rs = 0.795, U = 11.82, P <0.001, connective tissue disease and abnormal lung density increased significantly with the level of correlation. The average lung density and pixel distribution curve of 42 cases in 50 cases were normal. There were abnormalities in the average density of the lungs in 8 cases and abnormalities in the pixel distribution curve. There was no correlation between them. Conclusions The abnormalities of average lung density and pixel distribution curve are correlated with the extent and degree of interstitial lung disease caused by CTD. Abnormal lung density may have some value in the early diagnosis of interstitial lung disease caused by CTD.