Simple method for detecting idiopathic interstitial pneumonias by measuring vertical lung length on chest X-ray.
Simple method for detecting idiopathic interstitial pneumonias by measuring vertical lung length on chest X-ray.
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DOI：
10.1038/s41598-021-87452-z
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发表时间：
2021-04-07
影响因子：
4.6
通讯作者：
Suda T
中科院分区：
文献类型：
--
作者：
Karayama M;Aoshima Y;Yasui H;Hozumi H;Suzuki Y;Furuhashi K;Fujisawa T;Enomoto N;Nakamura Y;Inui N;Suda T
特发性间质性肺炎（IIPs）的胸部x线检查对非专科医生来说是困难的，特别是在轻度iip患者中。目前的研究旨在评估通过测量胸部x光片上的垂直肺长（VLL）来量化肺体积减少的一种检测IIPs的简单方法的有效性。共有280例连续IIPs患者被随机分配到探索性和验证性队列中，并通过倾向评分匹配为每个队列选择140例对照。在胸片上测量上（uVLL，从胸尖到气管隆突）、下（lVLL，从隆突到肋膈角）、总VLL （tVLL，从胸尖到肋膈角）及l/uVLL比值。与对照组相比，探索性队列患者的uVLL、lVLL、tVLL和l/uVLL比值显著降低（均p < 0.001）。受试者工作特征曲线分析表明，lVLL（曲线下面积[AUC] 0.86，灵敏度0.65，特异性0.92）、tVLL （AUC 0.83，灵敏度0.75，特异性0.80）和l/uVLL比值（AUC 0.80，灵敏度0.72，特异性0.79）对IIPs具有较高的诊断准确性。这些结果在验证队列中得到了重复。因此，IIP患者的VLL降低，因此测量VLL可能有助于准确检测IIP。
Detection of idiopathic interstitial pneumonias (IIPs) on chest X-ray is difficult for non-specialist physicians, especially in patients with mild IIPs. The current study aimed to evaluate the usefulness of a simple method for detecting IIPs by measuring vertical lung length (VLL) in chest X-rays to quantify decreased lung volume. A total of 280 consecutive patients with IIPs were randomly allocated to exploratory and validation cohorts, and 140 controls were selected for each cohort by propensity score-matching. Upper (uVLL; from apex to tracheal carina), lower (lVLL; from carina to costophrenic angle), and total VLL (tVLL; from apex to costophrenic angle), and the l/uVLL ratio were measured on chest X-rays. Patients in the exploratory cohort had significantly decreased uVLL, lVLL, tVLL, and l/uVLL ratio compared with controls (all p < 0.001). Receiver operating characteristic curve analyses demonstrated that lVLL (area under the curve [AUC] 0.86, sensitivity 0.65, specificity 0.92), tVLL (AUC 0.83, sensitivity 0.75, specificity 0.80), and l/uVLL ratio (AUC 0.80, sensitivity 0.72, specificity 0.79) had high diagnostic accuracies for IIPs. These results were reproduced in the validation cohort. IIP patients thus have decreased VLLs, and measurements of VLL may thus aid the accurate detection of IIPs.
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