Idiopathic pulmonary fibrosis: Physiologic tests, quantitative CT indexes, and CT visual scores as predictors of mortality
Idiopathic pulmonary fibrosis: Physiologic tests, quantitative CT indexes, and CT visual scores as predictors of mortality
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DOI：
10.1148/radiol.2463062200
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发表时间：
2008-03-01
期刊：
影响因子：
19.7
通讯作者：
Lynch, David A.
中科院分区：
文献类型：
--
作者：
Best, Alan C.;Meng, Jiangfeng;Lynch, David A.
目的：回顾性评估定量计算机断层扫描（CT）指数，肺功能检查结果，和视觉CT评分作为死亡率的预测因子，并描述连续变化的定量CT指数超过12个月的特发性肺纤维化（IPF）患者。材料和方法：机构审查委员会的批准和知情同意书在所有参与机构。167例IPF患者（110例男性，57例女性;平均年龄63岁+/- 9岁[标准差]）入组了一项临床试验。患者在入组时（基线）和12个月随访时在仰卧位完全吸气时接受薄层CT检查。分割肺后，测量平均肺衰减（MLA）、偏度和峰度。目视评估磨玻璃样阴影和肺纤维化的程度。测定用力肺活量（FVC）和总肺容量（TLC）。死亡率的中位随访时间为1.5年。单变量和多变量生存分析被用来确定基线变量对survival.Results的预测值：在单变量分析，基线变量预测死亡包括TLC，纤维化，偏度，峰度。在多变量分析中，FVC（P = 0.006）和纤维化（P = 0.002）是短期死亡率的预测因子。在95例同时进行基线和随访CT扫描的患者中，纤维化（P = 0.030）、MLA（P = 0.003）、偏度（P <0.001）和峰度（P <0.001）均显示变化，表明疾病进展。定量CT测量的系列评价可以显示这些患者的疾病进展。(c)RSNA，2008年。
Purpose: To retrospectively evaluate quantitative computed tomographic (CT) indexes, pulmonary function test results, and visual CT scoring as predictors of mortality and to describe serial changes in quantitative CT indexes over 12 months in patients with idiopathic pulmonary fibrosis (IPF).Materials and Methods: Institutional review board approval and informed consent were obtained at all participating institutions. One hundred sixty-seven patients (110 men, 57 women; mean age, 63 years +/- 9 [standard deviation]) with IPF were enrolled in a clinical trial. Patients underwent thin-section CT in the supine position at full inspiration at enrollment (baseline) and at 12-month follow-up. After segmentation of the lungs, mean lung attenuation (MLA), skewness, and kurtosis were measured. Extent of ground glass opacity and lung fibrosis were assessed visually. Forced vital capacity (FVC) and total lung capacity (TLC) were measured. Median duration of follow-up for mortality was 1.5 years. Univariate and multivariate survival analyses were used to determine the predictive value of baseline variables for survival.Results: At univariate analysis, baseline variables predictive of death included TLC, fibrosis, skewness, and kurtosis. At multivariate analysis, FVC (P = .006) and fibrosis (P = .002) were predictors of short-term mortality. In 95 patients who had both baseline and follow-up CT scans, fibrosis (P = .030), MLA (P = .003), skewness (P < .001), and kurtosis (P < .001) all showed change indicating disease progression.Conclusion: Visually determined disease extent on CT images is a strong independent predictor of mortality in IPF. Serial evaluation of quantitative CT measures can show disease progression in these patients. (c) RSNA, 2008.