摘要
目的 探讨定量CT有效识别2型糖尿病(T2DM)并发肺间质异常的敏感影像学指标,旨在帮助T2DM合并间质性肺病的早期诊断。方法 回顾性收集陕西中医药大学附属医院2022年1月~2023年8月临床确诊的T2DM患者且胸部CT发现肺间质异常的患者70例,同时收集胸部CT无异常改变的非糖尿病体检筛查者62例。采用Dexin-FACT“数字肺”软件对胸部CT图像进行后处理,获得各项CT定量参数,主要包括全肺容积、肺气肿指数(LAA-950%)、肺纤维化评价指标(LAA-700~-200%)、肺小血管指标(双肺下叶内2 mm支气管周围的血管管腔面积与数量之比,TAV/TNV)。比较两组间定量CT参数的差异性,并进行ROC曲线分析。结果 T2DM患者组的LAA-700~-200%高于对照组(Z=-4.229,P<0.001),而T2DM患者组的LAA-950%及TAV/TNV低于对照组(Z=-2.173,P<0.05;t=-3.904,P<0.001);两组间全肺容积的差异无统计学意义(P>0.05)。LAA-700~-200%区分T2DM并发肺间质异常的诊断效能最高,AUC为0.71。结论 T2DM并发肺间质异常患者的肺部CT定量参数与对照组相比具有差异性,而且肺部小血管损伤可能是T2DM患者肺损伤的关键靶器官。
Objective To explore the sensitive imaging indicators of effective recognition of type 2 diabetes mellitus(T2DM)complicated with interstitial lung abnormalities by quantitative CT,aim at contributing to the early diagnosis of T2DM complicated with interstitial lung disease and effectively delaying the progression of diabetic lung damage.Methods Seventy patients with clinically diagnosed T2DM with interstitial lung abnormalities detected on chest CT from January 2022 to August 2023 at the Affiliated Hospital of Shaanxi University of Chinese Medicine were retrospectively collected,and 62 non-diabetic physical examination screeners without abnormal changes on chest CT were also collected.The chest CT images were postprocessed by Dexin-FACT"digital lung"software,and the quantitative parameters of CT were obtained,including whole lung volume,emphysema index(LAA-950%),pulmonary fibrosis evaluation index(LAA-700~-200%),pulmonary small vessel index(the ratio of lumen area to number of blood vessels around the bronchus with a diameter of 2mm in the lower lobe of the lung,TAV/TNV).The differences of quantitative CT parameters between the two groups were compared and the indexes with statistical significance were analyzed by ROC curve.Results the LAA-700--200%in the T2DM group was significantly higher than that in the control group(Z=-4.229,P<0.001),while the LAA-950%and TAV/TNV in the T2DM group were significantly lower than those in the control group(Z=-2.173,P<0.05;t=-3.904,P<0.001),but there was no significant difference in whole lung volume between the two groups(P>0.05).LAA-700--200%had the highest diagnostic efficiency in distinguishing T2DM complicated with interstitial lung abnormalities,with an AUC of 0.71.Conclusion The quantitative parameters of lung CT in patients with T2DM complicated with interstitial lung abnormalities are different from those in the control group,and small blood vessel injury in the lung may be a key target organ for lung injury in T2DM patients.
作者
张丽
樊秋菊
党珊
韩冬
张敏
于楠
ZHANG Li;FAN Qiuju;DANG Shan;HAN Dong;ZHANG Min;YU Nan(School of Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Department of Medical Imaging,Affiliat-ed Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)
出处
《分子影像学杂志》
2024年第2期177-182,共6页
Journal of Molecular Imaging
基金
陕西科技厅基础研究项目(2022JM-453)
陕西省教育厅青年创新团队项目(23JP036)。
关键词
糖尿病
肺间质异常
定量分析
肺损害
CT
diabetes mellitus
interstitial lung abnormalities
quantitative analysis
lung damage
CT
