| Objective:The aim of this study was to quantitative measurement of small pulmonary cross-sectional area of subsegmental and sub-subsegmental pulmonary small vessels of COPD patients based on HRCT,analysis of the correlation between the percentage of the total cross-sectional area of small pulmonary vessel in the lung axial area(%CSA)and clinical pulmonary function test indexes as well as pulmonary artery/aortic(PA/A),percentage of low attenuation area of volume(LAV%).To investigate the value of%CSA from HRCT in evaluating the severity of chronic obstructive pulmonary disease.Methods:105 COPD patients and 100 healthy controls underwent chest HRCT scans and pulmonary function tests(PFT)in our hospital from January 2019 to January 2020.According to PFT,COPD patients were divided into mild group(33 cases),moderate group(35 cases)and severe group(37 cases).The%CSA less than 5mm2 and 5-10mm2 for the pulmonary(%CSA<5 and%CSA5-10)of pulmonary small vessel cross-sectional area were measured and analyzed using Image J image processing program.The t test was used to compare the%CSA<5 and%CSA5-10 between the COPD group and the control group.The correlation between%CSA and PFT,as well as PA/A and LAV%,was evaluated by the Spearman rank correlation test.Using the area under the ROC curve to evaluate%CSA in order to evaluate the diagnostic efficacy of COPD.Results:1.General information There were 100 cases of normal control group,105cases of COPD group.There was no statistically significant difference in basic data such as gender,age,height,weight among the two groups.2.In terms of%CSA:%CSA in the COPD group is significantly lower than that in the control group.%CSA<5 of COPD groups and control goups were 0.53±0.13 and 0.79±0.10(t=8.531,P<0.01),respectively;%CSA5-10 of two groups were(0.19±0.06)and(0.29±0.09)(t=4.883,p<0.01),respectively.%CSA<5 in the COPD group decreased with the increase of disease severity,which were(0.65±0.11),(0.54±0.10)and(0.46 ±0.11)(P<0.01);%CSA5-10 also decreased with the severity of the disease,but there was no statistically significant difference between the mild group and the moderate group,the moderate group and the severe group(P>0.05).3.PFT,PA/A and LAV%:FEV1%,FEV1/FVC,and MMEF%in the COPD group were significantly smaller than those in the control group;Fres was higher than the control group(P<0.01).The PA/A and LAV%of the COPD group were higher than those of the control group.The PA/A of the two groups were(0.79±0.13)and(0.69 ± 0.47)(P<0.01),respectively.There was no statistically significant difference in PA/A between the mild and moderate COPD groups(P>0.05),and the LAV%difference between the COPD groups was statistically significant(F=99.08,P<0.01).4.The correlation between%CSA and PFT,PA/A and LAV%:%CSA<5 is positively correlated with FEV1%,FEV1/FVC,MMEF%in the COPD group,%CSA<5 is correlated negative with Fres,(r=0.586?0.543?0.628?0.421,respectively.In addition,%CSA5-10 is also positively correlated with FEV1%,FEV1/FVC,MMEF%,and negatively correlated with Fres,but the correlation coefficients are less than%CSA<5,(r=0.402,0.339,0.381,0.322,respectively).%CSA is negatively correlated with LAV%and PA/A in COPD group.%CSA<5 is strongly correlated with LAV%(r=0.787),and moderately correlated with PA/A(r=0.477);%CSA5-10 is negatively correlated with LAV%and PA/A(r=0.528,0.326 respectively).Conclusion:The measurement and analysis of pulmonary small vessels in HRCT images correlated with PFT,LAV%,and PA/A,which has played an important role in evaluating the severity of COPD. |
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