摘要
目的:探讨计算机断层扫描(CT)肺功能成像技术对肺癌放射治疗后复发患者靶动脉灌注化疗前后肺功能变化评价的价值。方法:回顾性分析医院收治的30例放射治疗后复发且实施靶动脉灌注化疗肺癌患者的临床资料,分别于靶动脉灌注化疗前后采用CT肺功能成像检查,统计CT值、像素指数(PI)检查参数;对比靶动脉灌注化疗前后肺功能第1秒用力呼吸容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气量占所有呼气量的比例(FEV1/FVC)、功能残气量(FRC)、肺总量(TLC)、一氧化碳弥散量(DLco)和残气容积(RV)指标;分析CT肺功能成像检查参数与肺功能指标的相关性。结果:患者靶动脉灌注化疗前和化疗后CT值分别为-807.52±30.01和-839.57±31.25,差异有统计学意义(t=22.358,P<0.05);吸气像PI-800^-900和PI-920以及呼气像PI0~400、PI-400^-700和PI-700^-800均明显低于化疗前,差异有统计学意义(U吸气像=10.169,U=7.805;U呼气像=6.328,U=19.154,U=15.208;P<0.05);吸气像PI-900、PI-910、PI-930、PI-940和PI-950呼气像PI-800^-900、PI-900、PI-910、PI-920、PI-930、PI-940和PI-950均明显高于化疗前,差异有统计学意义(U吸气像=17.183,U=12.155,U=19.368,U=22.104,U=29.768;U呼气像=19.868,U=42.407,U=32.103,U=35.296,U=20.207,U=18.754,U=16.936;P<0.05);靶动脉灌注化疗后FEV1、FVC、FEV1/FVC、FRC、TLC及DLco均低于化疗前,差异有统计学意义(t=7.968,t=7.644,t=4.256,t=6.442,t=5.879,t=11.062;P<0.05),而化疗前后RV比较差异无统计学意义;CT肺功能成像参数中CT值、吸气像PI-800^-900、PI-920、呼气像PI0^-400、PI-400^-700、PI-700^-800与各项肺功能指标均呈正相关(P<0.05),吸气像PI-900、PI-910、PI-930、PI-940、PI-950、呼气像PI-800^-900、PI-900、PI-910、PI-920、PI-930、PI-940、PI-950与各项肺功能指标均呈负相关。结论:肺癌放射治疗后复发患者靶动脉灌注化疗后CT肺功能成像参数和肺功能指标均可出现不同程度异常,且二者具有相关性,可用CT肺功能成像参数评价化疗药物的毒性。
Objective:To explore the value of evaluation on computer tomography(CT)pulmonary function imaging technique on pulmonary function changes of patients with recurrent lung cancer post radiotherapy before and after target artery infusion chemotherapy.Methods:The clinical data of 30 patients with lung cancer recurrence post radiotherapy who underwent target artery infusion chemotherapy were retrospectively analyzed.All of them received the examination of CT pulmonary function imaging before and after target artery infusion chemotherapy.The examination parameters included CT values and pixel indexes(PI)were calculated by statistic method.The first second forced expiratory volume(FEV1),forced vital capacity(FVC),the ratio of the first second forced expiratory volume in forced vital capacity(FEV1/FVC),functional residual capacity(FRC),total lung capacity(TLC),diffusion capacity for carbon monoxide of the lung(DLCO)and residual volume(RV)between before and after target artery infusion chemotherapy were compared.The relationships between the parameters of CT pulmonary function imaging examination and pulmonary function indexes were further analyzed.Results:The CT values of patients before and after target artery infusion chemotherapy were-807.52±30.01 and-839.57±31.25 respectively,and the difference of CT values between them was statistically significant(t=22.358,P<0.05).The inspiratory PI-800^-90 and PI-920,and expiratory PI0~400,PI-400^-700 and PI-700^-800 after target artery infusion chemotherapy were significantly lower than those before chemotherapy(Uinspiratory pixel=10.169,U=7.805,Uexpiratory pixel=6.328,U=19.154,U=15.208,P<0.05).The inspiratory PI-900,PI-910,PI-930,PI-940 and PI-950,and expiratory PI-800^-900,PI-900,PI-910,PI-920,PI-930,PI-940 and PI-950 after chemotherapy were significantly higher than those before chemotherapy(Uinspiratory pixel=17.183,U=12.155,U=19.368,U=22.104,U=29.768,Uexpiratory pixel=19.868,U=42.407,U=32.103,U=35.296,U=20.207,U=18.754,U=16.936,P<0.05).The FEV1,FVC,FEV1/FVC,FRC,TLC and DLco after target artery infusion chemotherapy were significantly lower than those before chemotherapy(t=7.968,t=7.644,t=4.256,t=6.442,t=5.879,t=11.062,P<0.05),but there was no significant difference in RV between before and after chemotherapy.In CT pulmonary function imaging parameters,CT value,inspiratory PI-800^-90 and PI-920,and expiratory PI0^-400,PI-400^-700 and PI-700^-800 were positively correlated with each pulmonary functional index(P<0.05),and inspiratory PI-900,PI-910,PI-930,PI-940 and PI-950,and expiratory PI-800^-900,PI-900,PI-910,PI-920,PI-930,PI-940 and PI-950 were negatively correlated with above lung function indexes(P<0.05),respectively.Conclusion:Both CT pulmonary function imaging parameters and pulmonary function indexes of patients with recurrent lung cancer post target artery infusion chemotherapy might be abnormal in various degree,and they are relative.CT pulmonary function imaging parameters can be used to evaluate the toxicity of chemotherapeutics.
作者
党荣广
韩鲁军
杨晔
张燕
刘欣燕
董英辉
DANG Rong-guang;HAN Lu-jun;YANG Ye(Department of Oncology,The First Hospital of Shijiazhuang,Shijiazhuang 050000,China)
出处
《中国医学装备》
2020年第10期35-39,共5页
China Medical Equipment
基金
河北省医学科学研究计划(20191462)“4D-CT和变形图像配准功能成像在肺癌放疗后复发靶动脉灌注化疗后肺病毒性的预测价值”。
关键词
肺癌
放射治疗
靶动脉灌注化疗
肺功能
肺功能成像
Lung cancer
Radiotherapy
Target artery infusion chemotherapy
Pulmonary function
Pulmonary function imaging
