慢性阻塞性肺疾病患者CT分段纹理特征及与肺功能指标的关系分析

doi:10.3969/j.issn.1006-6233.2024.08.013

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摘要 目的: 分析慢性阻塞性肺疾病(COPD)患者CT分段纹理特征及与肺功能指标的关系。方法: 选取2022年3月至2023年3月期间80例COPD患者为研究对象(纳入研究组),同时期于本院接受体检的60例健康人员(纳入对照组),均行高分辨率CT扫描、CT分段纹理特征及肺功能测试,比较两组肺功能指标[第1s用力呼气容积占预计值百分比(FEV1%)、用力肺活量(FVC)、FEV1/FVC]及全肺区域及肺外带区域纹理特征,分析CT纹理特征与肺功能指标的相关性。结果: 两组年龄、性别比较差异均无统计学意义(P>0.05),研究组FEV1%、FVC、FEV1/FVC均小于对照组,差异均有统计学意义(P<0.05);研究组全肺GLCM对比度、全肺GLCM熵、全肺GLSZM区域大小非均匀性、肺外带GLCM对比度、肺外带GLCM熵、肺外带GLSZM区域大小非均匀性、肺外带LBP特征值均高于对照组,差异均有统计学意义(P<0.05);Pearson相关性分析显示,全肺GLCM对比度、全肺GLCM熵、全肺GLSZM区域大小非均匀性、肺外带GLCM对比度、肺外带GLCM熵、肺外带GLSZM区域大小非均匀性、肺外带LBP特征值与FEV1%、FVC、FEV1/FVC均呈负相关性,差异均有统计学意义(P<0.05);多元回归分析结果显示,全肺GLCM对比度、全肺GLCM熵、全肺GLSZM区域大小非均匀性、肺外带GLCM对比度、肺外带GLCM熵、肺外带GLSZM区域大小非均匀性、肺外带LBP特征值对COPD患者FEV1%、FVC和FEV1/FVC均具有显著影响(P<0.05),R2值分别为0.682、0.657、0.715,提示模型拟合优度较高。结论: CT分段纹理特征与COPD患者的肺功能指标密切相关,其中全肺和肺外带区域的GLCM对比度、GLCM熵、GLSZM区域大小非均匀性及LBP特征值可作为COPD影像学评估和早期诊断的重要参考指标。

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关键词 ：高分辨率CT, 纹理特征分析, 慢性阻塞性肺疾病, 肺功能

Abstract：Objective: To analyze the CT segmented texture characteristics and the relationship with pulmonary function indicators in patients with chronic obstructive pulmonary disease (COPD).Methods: From March 2022 to March 2023, 80 patients with COPD were selected as the study subjects (study group), and 60 healthy people who received physical examination in the hospital were included in the control group. All patients underwent high-resolution CT scans and CT segmented texture characteristics and pulmonary function tests. The pulmonary function indicators [forced expiratory volume in the first second as a percentage of predicted value FEV1%), forced vital capacity (FVC), FEV1/FVC] and texture characteristics of the whole lung region and the outer lung region were compared between the two groups The correlation between CT texture characteristics and pulmonary function indicators was analyzed.Results: There were no statistical differences in age and gender between groups (P>0.05). The FEV1%, FVC, and FEV1/FVC in the study group were lower than those in the control group (P<0.05). The whole lung GLCM contrast, whole lung GLCM entropy, whole lung GLSZM area size non-uniformity, outer lung GLCM contrast, outer lung GLCM entropy, outer lung GLSZM area size non-uniformity, and outer lung LBP eigenvalue in the study group were higher than those in the control group (P<0.05). Pearson correlation analysis showed that whole lung GLCM contrast, whole lung GLCM entropy, whole lung GLSZM area size non-uniformity, outer lung GLCM contrast, outer lung GLCM entropy, outer lung GLSZM area size non-uniformity, and outer lung LBP eigenvalue were negatively correlated with FEV1%, FVC and FEV1/FVC (P<0.05). Multivariate regression analysis showed that whole lung GLCM contrast, whole lung GLCM entropy, whole lung GLSZM area size non-uniformity, outer lung GLCM contrast, outer lung GLCM entropy, outer lung GLSZM area size non-uniformity, and outer lung LBP eigenvalue had significant effects on FEV1%, FVC and FEV1/FVC in patients with COPD (P<0.05), and the R2 values were 0.682, 0.657 and 0.715 respectively, suggesting that the model had high goodness of fit.Conclusion: CT segmented texture characteristics are closely related to pulmonary function indicators of COPD patients. The GLCM contrast, GLCM entropy, GLSZM area size non-uniformity, and LBP eigenvalue of the whole lung and outer lung can be used as important reference indicators for imaging evaluation and early diagnosis of COPD.

Key words： High-resolution CT Texture characteristics analysis Chronic obstructive pulmonary disease Pulmonary function

基金资助:河北省2018年度医学科学研究重点课题,(编号:20180650);河北省科技计划项目,(编号:182777131)

通讯作者: 郑国利

引用本文:

王彩彩, 王媛, 李江涛, 郭玉曼, 孟静, 李艳君, 郑国利. 慢性阻塞性肺疾病患者CT分段纹理特征及与肺功能指标的关系分析[J]. 河北医学, 2024, 30(8): 1304-1309.
WANG Caicai, WANG Yuan, LI Jiangtao, et al. Analysis of CT Segmental Texture Characteristics and Relationship with Pulmonary Function Indices in COPD Patients. HeBei Med, 2024, 30(8): 1304-1309.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.08.013 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I8/1304

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