运用肺气肿自动定量软件CIP评估COPD患者肺叶功能的研究

汤婷婷 谭松 武扬平 管二梅

摘要：目的  探讨运用CIP软件自动分割肺叶、定量分析单个肺叶及全肺肺气肿指数在评估慢性阻塞性肺疾病患者肺叶功能中的价值。方法  选取2018年7月～12月在我院就诊和住院的稳定期COPD患者23例，行胸部CT薄层扫描，运行CIP软件对其肺叶进行自动分割，定量测定各肺叶及全肺肺气肿指数。结果  CIP软件能将肺叶进行自动分割及计算肺气肿指数，直观了解病变分布的位置，能得到各个肺叶的损伤数据，23例COPD患者中肺气肿1级18例，2级5例。结论  CIP软件可以较好的消除人为因素的影响，快速准确的定量计算肺气肿指数，明确责任肺叶组织的损伤程度，为评估肺储备功能及外科肺减容手术提供参考依据。

关键词：肺气肿指数;CIP;自动定量;慢性阻塞性肺疾病

中图分类号：R816.4;R563                             文獻标识码：A                             DOI：10.3969/j.issn.1006-1959.2019.13.050

文章编号：1006-1959（2019）13-0157-03

Abstract：Objective  To explore the value of using CIP software to automatically segment lung lobes， quantitative analysis of single lung lobe and whole lung emphysema index in evaluating lung function in patients with chronic obstructive pulmonary disease. Methods  A total of 23 patients with stable COPD who were admitted to our hospital from July to December 2018 were enrolled in this study.Thoracic CT thin-layer scanning was performed， and CIP software was used to automatically segment the lung lobe， and the lung lobe and whole lung emphysema index were quantitatively determined.Results  CIP software can automatically segment the lobes and calculate the emphysema index， visually understand the location of the lesions， and obtain the damage data of each lung lobe. In 23 patients with COPD， 18 patients had grade 1 emphysema and 5 patients had grade 2. Conclusion  CIP software can better eliminate the influence of human factors， quickly and accurately calculate the emphysema index， and determine the degree of damage of the responsible lung tissue， and provide reference for the evaluation of lung reserve function and surgical lung volume reduction surgery.

Key words：Emphysema index;CIP;Automatic quantification;Chronic obstructive pulmonary disease

慢性阻塞性肺疾病（COPD）是危害人类健康的常见疾病，晚期严重影响患者呼吸功能，病死率高。有研究表明[1]，右肺尤其是右肺下叶是肺气肿主要责任肺叶，此肺叶出现异常能反映COPD 的早期病变。因此，早期、准确地评估肺气肿对改善预后及降低死亡率具有十分重要的意义。目前临床上常用肺功能检查（PFT）评价肺气肿，但其受年龄、性别、体质量指数、测定时间及操作手法等的影响，可重复性差，仅能对全肺的肺功能进行评价，有一定的局限性。近年随着肺减容手术、肺移植的开展，CT功能定量成像成为国外研究的热点[2]。既往CT功能定量成像研究仅局限于全肺容积成像的范畴，对于单侧肺，尤其是肺叶功能研究较少，难以满足外科手术精准定位的需求。……