Abstract
OBJECTIVE: To investigate the value of multiplanar reconstruction (MPR) technology in the quantitative analysis of bronchovascular bundle (BVB) for staging pneumoconiosis. METHODS: We retrospectively analyzed CT data from 65 patients with confirmed pneumoconiosis (42 stage I, 16 stage II, 7 stage III) at Hefei Third People's Hospital between January 2020 and March 2025. MPR was used to measure the bronchial wall thickness-to-diameter ratio (WT/D), the vascular bifurcation angle variation index (AVI), and the peribronchial fractal dimension (FD). Feature parameters were selected using Lasso regression, and diagnostic efficacy was evaluated using ROC curves. RESULTS: Significant intergroup differences were observed: the stage III group showed significantly higher WT/D, AVI, and FD values than the stage I group (p < 0.001). The positivity rate for the cuffing sign was higher in the stage II group compared to the stage I group (p = 0.003). The combined parameters (WT/D + AVI + FD) achieved an AUC of 0.911, with a sensitivity of 92.3% and specificity of 88.6%, outperforming individual parameters (p = 0.002). AVI positively correlated with the vascular calcification score (p < 0.001), while FD negatively correlated with lung volume (p = 0.001). The interobserver intraclass correlation coefficient (ICC) for WT/D measurements reached 0.923, and the diagnostic concordance rate for stage III was 100%. CONCLUSION: MPR technology can quantify structural distortions of the BVB in pneumoconiosis. The combined parameter model provides an objective imaging basis for the clinical staging of pneumoconiosis.