EMPHYSEMA - DEFINITION, IMAGING, AND QUANTIFICATION
EMPHYSEMA - DEFINITION, IMAGING, AND QUANTIFICATION
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DOI：
10.2214/ajr.163.5.7976869
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发表时间：
1994-11-01
影响因子：
5
通讯作者：
MULLER, NL
中科院分区：
文献类型：
--
作者：
THURLBECK, WM;MULLER, NL
本文将讨论肺气肿患者的胸部影像学检查。影像学检查结果必须与肺的结构有关，因为肺气肿是在解剖学术语中定义的。因此，我们首先回顾了肺气肿的解剖学定义及其后果，然后回顾了这种疾病患者的影像学表现，重点是CT。无论采用何种标准，形态学肺气肿越严重，影像学诊断的可能性就越大。动脉供血不足的标准是特异性的，但不敏感。用于评估过度通货膨胀的标准很敏感，但并不具体。CT可用于肺气肿的定性和定量评估。肺气肿的存在和程度可以通过对异常低衰减区域的视觉评估或通过基于衰减值的客观定量来确定。大量研究显示肺气肿与CT表现之间存在统计学显著相关性，但CT可能会漏诊轻度形态学肺气肿，偶尔CT扫描会出现假阳性结果。在中度至重度肺气肿患者中，当与肺标本的病理检查结果直接比较时，根据CT结果，肺气肿的严重程度被低估了约3倍。尽管存在这些局限性，CT仍是识别肺气肿的最佳方法，并且在识别适合手术治疗的局限性肺气肿方面可能具有重要作用。
This review will discuss imaging of the chest in patients with pulmonary emphysema. Imaging findings must be related to the structure of the lung because emphysema is defined in anatomic terms. Accordingly, we first review the anatomic definitions of emphysema and its consequences and then review the imaging findings, with emphasis on CT, in patients with this disease. The more severe the morphologic emphysema, the more likely a radiographic diagnosis will be made, no matter what criteria are used. The criterion of arterial deficiency is specific but insensitive. The criteria used to assess overinflation are sensitive but not specific. CT can be used for both qualitative and quantitative assessment of emphysema. The presence and extent of emphysema can be determined by visual assessment of areas of abnormally low attenuation or by objective quantification based on the attenuation values. Statistically significant correlations between emphysema and CT findings have been shown in numerous studies, but mild morphologic emphysema may be missed by CT, and occasionally CT scans give false-positive findings. In patients with moderate to severe emphysema, the severity of emphysema is underestimated on the basis of CT findings by a factor of approximately three when compared directly with results of pathologic examination of lung specimens. In spite of these limitations, CT is the best way of recognizing emphysema in living patients and probably has a significant role in recognizing localized emphysema that is amenable to surgical treatment.