ObjectiveTo investigate the application value of chest CT quantitative technology in evaluating pulmonary function in patients with chronic obstructive pulmonary disease(COPD).
MethodsThe CT parametersincluding the low attenuation area percentage(LAA%), end-expiration lung volume/end-expiration lung volume(Vex/Vin), ratio of end-expiration and end-inspiratory CT average lung density(MLD(ex/in), lowest 1% lung attenuation value(Prec1) and lowest 15% attenuation value(Prec15), lung function test resultsincluding the total lung capacity(TLC), residual capacity(RV), forced vital capacity(FVC), residual capacity to total lung capacity(RV/TLC), forced expiratory volume and forced vital capacity percentage in 1 second(FEV1/FVC), FEV1 forced expiratory volume in 1 second as a percentage of predicted value(FEV1%), and cardiac indicatorsincluding the left ventricular ejection fraction(LVEF), left ventricular diameter(LVD), left atrial diameter(LAD), right ventricular diameter(RVD) and right atrial diameter(RAD) in 95 simple COPD patients with different degrees of illness were detected using chest CT quantitative technology, and compared.Fifty-three lung cancer complicated with COPD patients scheduled by operation were selected, the CT parameters of patients with different conditions of cardiopulmonary complications after operation were compared, and the predictive value of CT parameters to the prognosis of patients was analyzed using the receiver operating characteristic curve.
ResultsWith the exacerbation of COPD patients, the total LAA ratio, right lung ratio, left lung ratio, Vex/Vin, EI, MLD (ex/in), Prec1 and Prec15 showed an upward trend, the FVC, FEV1, FEV1% and FEV1/FVC showed a decreasing trend, the RV, TLC and RV/TLC showed an increasing trend, the RVD showed an increasing trend, and the LVEF showed a decreasing trend, and the differences of the above parameters among the patients with different degrees of disease were statistically significant(P < 0.05 to P < 0.01).The LAA%, Vex/Vin, EI, MLD(ex/in), Prec1 and Prec15 were negatively correlated with the FVC, FEV1, FEV1%, FEV1/FVC and LVEF, and positively correlated with the RV, TLC, RV/TLC and RVD(P < 0.05 to P < 0.01).Among the 53 patients, 14 patients with cardiopulmonary complications after surgery(including 4 patients with arrhythmia) were found.The preoperative LAA%, Vex/Vin, EI, MLD(ex/in), Prec1 and Prec15 in patients with cardiopulmonary complications were higher than those in patients without cardiopulmonary complications(P < 0.05).The AUC of proportion of LAA in the left lung in predicting cardiopulmonary complications was 0.819.When the cutoff value was more than 32.53%, the sensitivity and specificity were 71.43% and 84.62%, respectively.
ConclusionsWith the progress of COPD, the excessive lung expansion will lead to the cardiac function decreasing.The parameters of CT quantitative technology are closely related to cardiac function and pulmonary function, which can be used to detect lung function and can also be used to predict the occurrence of cardiopulmonary complications in patients with lung cancer complicated with COPD after lobectomy.
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