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目的探讨CT肺功能定量指标分析对三维适形放疗(3DCRT)放射性肺损伤的早期诊断价值。方法搜集本院2008年1月至2011年12月经病理确诊为肺癌后行3DCRT的52例患者临床随访资料。调取每位患者3DCRT之前与之后第1、3、6、9、12个月影像随访资料,由3位高级职称医师对肺部影像表现作出评价,并对发现的放射性肺损伤进行分级,同时利用西门子工作站Pulmo软件进行CT肺功能定量分析,观察相关CT定量指标变化。应用SPSS 13.0统计软件对数据进行统计学分析。结果 3DCRT后第1个月CT肺功能定量分析发现:“PI-900/-801”值较放疗前降低(t=1.710,P<0.05),有42例减低,10例稍增高;“PI-800/-701”、“双侧肺的肺平均密度(MLD)”等数值较放疗前均无明显变化(t=1.315,P>0.05);而通过肺部CT影像形态学改变有22例。3DCRT后第3个月CT肺部定量分析示,“PI-900/-801”值52例均出现明显降低(t=2.573,P<0.01),患侧肺“PI-800/-701”及“MLD”明显增高(t=2.611;t=2.607,P<0.01),差异有统计学意义;经肺部CT影像形态学观察所照射肺野透亮度均有不同程度增高。结论利用定量CT肺功能“PI-900/-801”指标能够发现3DCRT后第1个月复查肺部影像形态学结果为阴性的肺部放射性轻微损伤,其对临床提前干预放射性肺损伤具有一定的参考价值。
Objective To investigate the value of quantitative analysis of CT pulmonary function in the early diagnosis of three-dimensional conformal radiation therapy (3DCRT) radiation-induced lung injury. Methods The clinical follow-up data of 52 patients with 3DCRT who were pathologically diagnosed as lung cancer from January 2008 to December 2011 were collected. The 3D MRT images of each patient before and after 1, 3, 6, 9 and 12 months of follow-up were collected and evaluated by three senior professional physicians on the performance of lung imaging and the classification of radiation-induced lung injury. At the same time Using Pulmo software of Siemens workstation, quantitative analysis of CT pulmonary function was performed to observe the change of quantitative indexes of related CT. The data were statistically analyzed using SPSS 13.0 statistical software. Results Quantitative analysis of CT pulmonary function in the first month after 3DCRT showed that the PI-900 / -801 value was lower than that before radiotherapy (t = 1.710, P <0.05), 42 cases decreased and 10 cases slightly increased; The values of “PI-800 / -701 ” and “MLD” of bilateral lung did not change significantly compared with those before radiotherapy (t = 1.315, P> 0.05) Learning changes in 22 cases. CT lung quantitative analysis at the third month after 3DCRT showed that the value of “PI-900 / -801” was significantly lower in 52 cases (t = 2.573, P <0.01) (P <0.01). There was a significant difference between the control group (P <0.01) and MLD (t = 2.611; t = 2.607, P <0.01) . Conclusions Quantitative CT pulmonary function test “PI-900 / -801” can be used to find the lung radioactive lesion with negative lung morphological results in the first month after 3DCRT. It is of great value in the early clinical intervention of radiation lung injury Certain reference value.