计算机断层扫描和全身胸透测量肺容量的比较--系统综述。

IF 1.8 Q3 RESPIRATORY SYSTEM European Clinical Respiratory Journal Pub Date : 2024-07-29 eCollection Date: 2024-01-01 DOI:10.1080/20018525.2024.2381898
Høgni Janus Bjarnason Olsen, Jann Mortensen
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引用次数: 0

摘要

简介全身胸透是测量静态肺容量:总肺活量(TLC)、功能性残余肺活量(FRC)和残余容积(RV)的首选方法,因为它还包括慢性阻塞性肺病(COPD)中常见的滞留气体。定量计算机断层扫描(CT)是一种很有前景的胸透替代方法,但对于肺功能严重受损的患者来说,进行胸透具有挑战性。本系统性综述探讨了胸透和 CT 测量的肺容积之间的一致性,以及为优化这两种方法之间的一致性所做的尝试:采用分块检索策略在 PubMed 数据库中进行文献检索。同时提供基于 CT 和基于胸压测量的 TLC 的文章均被纳入。采用诊断准确性研究质量评估2(QUADAS-2)核对表对偏倚风险进行评估。与胸透 TLC(p-TLC)相比,CT 导出的 TLC(CT-TLC)平均低 709 mL,与参考标准 p-TLC 的偏差为 12.1%。这一差异(ΔTLC)在阻塞性患者中稍大(阻塞性:781 mL,非阻塞性:609 mL),而偏差百分比稍小(阻塞性:11.4%,非阻塞性:13.5%)。基于 CT 的 RV 分析主要基于 COPD 患者,测量结果比胸膜透射法(p-RV)高 603 毫升,与 p-RV 的偏差为 17.8%。在 CT 采集过程中使用肺活量门控技术的研究报告显示,不同模式之间的一致性很好(ΔTLC:70-280 mL),其中一项研究显示,在相同的研究环境下,与传统的屏气指导相比,CT 定量有明显改善:结论:与血气分析相比,CT 定量通常会低估 TLC 和高估 RV。肺活量门控可减少分歧程度,并可在患者已接受 CT 检查时提供帮助。不过,还需要进一步的研究来证实这些结果。
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Comparison of lung volumes measured with computed tomography and whole-body plethysmography - a systematic review.

Introduction: Whole-body plethysmography is the preferred method for measuring the static lung volumes: total lung capacity (TLC), functional residual capacity (FRC) and residual volume (RV), as it also incorporates trapped gas - a common finding in chronic obstructive pulmonary disease (COPD). Quantitative computed tomography (CT) is a promising alternative to plethysmography, which can be challenging to perform for patients with severely impaired lung function. The present systematic review explores the agreement between lung volumes measured by plethysmography and CT, as well as the attempts being made to optimize alignment between these two methods.

Methods: A literature search was performed on the PubMed database using the block search strategy. Articles were included if they provided both CT based and plethysmography based TLC. Risk of bias was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) checklist.

Results: 22 articles were included. On average, CT-derived TLC (CT-TLC) was 709 mL lower compared to plethysmography TLC (p-TLC) with a 12.1% deviation from the reference standard, p-TLC. This discrepancy (ΔTLC) appeared slightly larger in obstructive patients (obstructive: 781 mL, non-obstructive: 609 mL), whereas percent deviation was slightly smaller (obstructive: 11.4%, non-obstructive: 13.5%). CT-based RV analyses primarily based on COPD patients measured 603 mL higher than plethysmography (p-RV) with 17.8% deviation from p-RV. Studies utilizing spirometry-gating for CT acquisition reported good agreement between modalities (ΔTLC: 70-280 mL), and one study demonstrated noticeable improvements compared to conventional breath-hold instructions in an otherwise identical study setting.

Conclusion: CT quantifications routinely underestimate TLC and overestimate RV in comparison to plethysmography. Spirometry gating reduces the level of disagreement and can be of assistance when patients are already undergoing CT. However, further studies are needed to confirm these results.

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CiteScore
3.80
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0.00%
发文量
15
审稿时长
16 weeks
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