非对比CT上的肺动脉形态标志物预测慢性阻塞性肺疾病的急性加重和疾病进展：一项纵向队列研究

IF 2.1 4区医学

Japanese Journal of Radiology Pub Date : 2025-08-04 DOI:10.1007/s11604-025-01841-2

Xiaohe Yu, Ziqi Xiong, Jingxue Cao, Fang Wang, Xiao Bao, Jingyun Shi

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引用次数: 0

摘要

目的：探讨肺动脉定量CT （qCT）参数对慢性阻塞性肺疾病急性加重期（AECOPD）的预测价值，并探讨其纵向变化与肺功能下降的关系。材料与方法：本回顾性研究纳入2012-2024年XXX医院507例COPD患者。使用FACT-Digital系统分析非对比CT图像，得出qCT参数：血管≤5 mm2的动脉血容量（BV5），总气道计数（TAC）， -950 HU低衰减面积（LAA-950%）和总肺容量（TLV）。ROC曲线评估AECOPD的预测性能。多变量Cox回归评估了纵向qCT变化与结果（GOLD进展，FEV1下降至30/50 mL/年）之间的关系。结果：4个qCT参数（TLV、LAA-950%、TAC、动脉BV5）可建立1年内AE及频繁AE的预测模型。对于1年内AE预测，CT模型的AUC为0.817 (95% CI 0.762-0.872)，结合临床参数模型的AUC为0.839 （95% CI 0.803-0.875）。动脉BV5 30毫升/年(P = 0.008, HR = 2.256, 95% CI 1.237 - -4.115),残下降> 50毫升/年(P = 0.001, HR = 2.943, 95% CI 1.525 - -5.680)。结论：研究表明，小肺动脉容量（BV5）减少是AECOPD和疾病进展的独立危险因素。此外，在随访期间，小肺动脉容量的下降独立预测了GOLD分期的进展和肺功能的加速下降。

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Pulmonary arterial morphological markers on non-contrast CT predicted acute exacerbations and disease progression in chronic obstructive pulmonary disease: a longitudinal cohort study.

Purpose: To investigate the predictive value of pulmonary artery quantitative CT (qCT) parameters for acute exacerbations of COPD (AECOPD) and explore their longitudinal changes in relation to pulmonary function decline.

Materials and methods: This retrospective study included 507 COPD patients from XXX Hospital (2012-2024). Non-contrast CT images were analyzed using the FACT-Digital system to derive qCT parameters: arterial blood volume for vessels ≤ 5 mm² (BV5), total airway count (TAC), low attenuation area at -950 HU (LAA-950%), and total lung volume (TLV). ROC curves assessed predictive performance for AECOPD. Multivariable Cox regression evaluated associations between longitudinal qCT changes and outcomes (GOLD progression, FEV1 decline > 30/50 mL/year).

Results: Four qCT parameters (TLV, LAA-950%, TAC, and arterial BV5) were used to build predictive models for AE within 1 year and frequent AE. For AE within 1 year prediction, CT model achieved an AUC of 0.817 (95% CI 0.762-0.872), integration with clinical parameters model improved AUC to 0.839 (95% CI 0.803-0.875). Arterial BV5 < 23.715 ml and TAC < 131 emerged as independent predictors. For frequent AE prediction, CT model showed an AUC of 0.767 (95% CI 0.704-0.830), integration with clinical parameters model improved AUC to 0.867 (95% CI 0.825-0.909). Arterial BV5 < 18 ml and TAC < 135 were identified as independent predictors. Arterial BV5 decline was identified as a marginal independent risk factor for GOLD stage progression (P = 0.051, HR = 2.286, 95% CI 0.995-5.252), FEV1 decline > 30 mL/year (P = 0.008, HR = 2.256, 95% CI 1.237-4.115) and FEV1 decline > 50 mL/year (P = 0.001, HR = 2.943, 95% CI 1.525-5.680).

Conclusions: The study demonstrated that reduced small pulmonary arterial volume (BV5) is an independent risk factor for AECOPD and disease progression. Furthermore, during follow-up, decline in small pulmonary arterial volume independently predicted progression of GOLD stages and accelerated decline in lung function.

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来源期刊

Japanese Journal of Radiology Medicine-Radiology, Nuclear Medicine and Imaging

自引率

4.80%

发文量

133

期刊介绍： Japanese Journal of Radiology is a peer-reviewed journal, officially published by the Japan Radiological Society. The main purpose of the journal is to provide a forum for the publication of papers documenting recent advances and new developments in the field of radiology in medicine and biology. The scope of Japanese Journal of Radiology encompasses but is not restricted to diagnostic radiology, interventional radiology, radiation oncology, nuclear medicine, radiation physics, and radiation biology. Additionally, the journal covers technical and industrial innovations. The journal welcomes original articles, technical notes, review articles, pictorial essays and letters to the editor. The journal also provides announcements from the boards and the committees of the society. Membership in the Japan Radiological Society is not a prerequisite for submission. Contributions are welcomed from all parts of the world.