Validation of computed tomography for measuring lung weight.
Validation of computed tomography for measuring lung weight.
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DOI：
10.1186/s40635-014-0031-0
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发表时间：
2014-12
影响因子：
3.5
通讯作者：
Gattinoni L
中科院分区：
文献类型：
--
作者：
Protti A;Iapichino GE;Milesi M;Melis V;Pugni P;Comini B;Cressoni M;Gattinoni L
肺重量表征肺水肿的严重程度，并预测对机械通气的反应。本研究的目的是评估胸部计算机断层扫描（CT）定量分析的准确性，测量肺重量的猪有或没有肺水肿。36头猪采用不同的潮气量和呼气末正压进行机械通气，这些潮气量和呼气末正压会或不会诱导肺水肿。54 h后行胸部CT（CTin vivo）检查，处死动物，放血。14只猪接受了第二次胸部CT（CTpost-exsang.）在放血之后。切除肺并用天平称重（balancepost-exsang.）。使用Bland-Altman图评估了使用天平（视为参考）测量的肺重量与通过CT定量分析估计的肺重量之间的一致性。一只动物在体内CT前意外死亡。35头猪，用天平测肺重。CT在体测量的平均值为481 ± 189 g（P < 0.001）。方法之间的偏差为-111 g（-35%），一致性限为-176 g（-63%）和-46 g（-8%）。有（−112 ± 45 g; n = 11）或无（−110 ± 27 g; n = 24）肺水肿的动物的测量误差相似（p = 0.88）。14头猪放血后行胸部CT检查，用天平测肺重。CT检查后的平均值为342 ± 165 g。为352 ± 160 g（p = 0.02）。方法之间的偏倚为-9 g（-4%），一致性限为-36 g（-11%）和17 g（3%）。在有（−1 ± 26 g; n = 11）或无（−12 ± 7 g; n = 3）肺水肿的猪中，测量误差相似（p = 0.12）。与天平相比，体内获得的CT不断高估肺重量，因为它包括肺血（而天平不包括）。相比之下，放血后获得的CT提供了准确和可重复的结果。
Lung weight characterises severity of pulmonary oedema and predicts response to mechanical ventilation. The aim of this study was to evaluate the accuracy of quantitative analysis of thorax computed tomography (CT) for measuring lung weight in pigs with or without pulmonary oedema. Thirty-six pigs were mechanically ventilated with different tidal volumes and positive end-expiratory pressures that did or did not induce pulmonary oedema. After 54 h, they underwent thorax CT (CTin vivo) and were then sacrificed and exsanguinated. Fourteen pigs underwent a second thorax CT (CTpost-exsang.) after exsanguination. Lungs were excised and weighed with a balance (balancepost-exsang.). Agreement between lung weights measured with the balance (considered as reference) and those estimated by quantitative analysis of CT was assessed with Bland-Altman plots. One animal unexpectedly died before CTin vivo. In 35 pigs, lung weight measured with balancepost-exsang. was 371 ± 184 g and that estimated with CTin vivo was 481 ± 189 g (p < 0.001). Bias between methods was −111 g (−35%) and limits of agreement were −176 (−63%) and −46 g (−8%). Measurement error was similar in animals with (−112 ± 45 g; n = 11) or without (−110 ± 27 g; n = 24) pulmonary oedema (p = 0.88). In 14 pigs with thorax CT after exsanguination, lung weight measured with balancepost-exsang. was 342 ± 165 g and that estimated with CTpost-exsang. was 352 ± 160 g (p = 0.02). Bias between methods was −9 g (−4%) and limits of agreement were −36 (−11%) and 17 g (3%). Measurement errors were similar in pigs with (−1 ± 26 g; n = 11) or without (−12 ± 7 g; n = 3) pulmonary oedema (p = 0.12). Compared to the balance, CT obtained in vivo constantly overestimated the lung weight, as it included pulmonary blood (whereas the balance did not). By contrast, CT obtained after exsanguination provided accurate and reproducible results.