Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD.
Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD.
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DOI：
10.1186/1465-9921-14-42
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发表时间：
2013-04-08
影响因子：
5.8
通讯作者：
COPDGene Investigators
中科院分区：
文献类型：
--
作者：
Hersh CP;Washko GR;Estépar RS;Lutz S;Friedman PJ;Han MK;Hokanson JE;Judy PF;Lynch DA;Make BJ;Marchetti N;Newell JD Jr;Sciurba FC;Crapo JD;Silverman EK;COPDGene Investigators
胸部CT扫描上量化的气体捕获已被认为是COPD小气道疾病的替代方法。我们试图确定使用成对的吸气和呼气CT扫描的测量结果是否能够更好地区分肺气肿引起的气体捕获和小气道疾病引起的气体捕获。COPD基因研究中患有和不患有COPD的吸烟者接受了吸气和呼气胸部CT扫描。肺气肿以吸气CT上肺密度 <； −950HU的百分比来定量。定义了四种气体捕获指标：(1)呼气显像肺−856，肺 和Lt的百分比；(2)E/IMLA，呼气/吸气平均肺衰减率；(3)RVC856-950，呼气和吸气肺体积之差，−856和−950HU之间的衰减；(4)−856呼气和吸气肺体积之差对肺气肿百分比的影响。在有完整数据的85 17名受试者中，Exp−85 6与肺气肿高度相关。基于吸气和呼气CT扫描的测量结果与肺气肿的相关性较小。在所有受试者和非肺气肿受试者中，EXP−85 6、E/IMLA和RVC85 6-95 0可预测肺活量、运动能力和生活质量。在重度肺气肿患者中，E/IMLA和RVC856-950与临床变量的相关性最高。基于成对的吸气和呼气胸部CT扫描的定量测量可以作为患有和不患有COPD的吸烟者小气道疾病的标志，但这将需要未来的研究同时获得吸气和呼气CT扫描。
Gas trapping quantified on chest CT scans has been proposed as a surrogate for small airway disease in COPD. We sought to determine if measurements using paired inspiratory and expiratory CT scans may be better able to separate gas trapping due to emphysema from gas trapping due to small airway disease. Smokers with and without COPD from the COPDGene Study underwent inspiratory and expiratory chest CT scans. Emphysema was quantified by the percent of lung with attenuation < −950HU on inspiratory CT. Four gas trapping measures were defined: (1) Exp−856, the percent of lung < −856HU on expiratory imaging; (2) E/I MLA, the ratio of expiratory to inspiratory mean lung attenuation; (3) RVC856-950, the difference between expiratory and inspiratory lung volumes with attenuation between −856 and −950 HU; and (4) Residuals from the regression of Exp−856 on percent emphysema. In 8517 subjects with complete data, Exp−856 was highly correlated with emphysema. The measures based on paired inspiratory and expiratory CT scans were less strongly correlated with emphysema. Exp−856, E/I MLA and RVC856-950 were predictive of spirometry, exercise capacity and quality of life in all subjects and in subjects without emphysema. In subjects with severe emphysema, E/I MLA and RVC856-950 showed the highest correlations with clinical variables. Quantitative measures based on paired inspiratory and expiratory chest CT scans can be used as markers of small airway disease in smokers with and without COPD, but this will require that future studies acquire both inspiratory and expiratory CT scans.
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影响因子：
10
作者：
Martinez CH;Chen YH;Westgate PM;Liu LX;Murray S;Curtis JL;Make BJ;Kazerooni EA;Lynch DA;Marchetti N;Washko GR;Martinez FJ;Han MK;COPDGene Investigators
通讯作者：
COPDGene Investigators
影响因子：
5
作者：
Matsuoka, Shin;Kurihara, Yasuyuki;Nakajima, Yasuo
通讯作者：
Nakajima, Yasuo
影响因子：
158.5
作者：
HOGG, JC;MACKLEM, PT;THURLBECK, WM
通讯作者：
THURLBECK, WM
影响因子：
5.9
作者：
Mets OM;Murphy K;Zanen P;Gietema HA;Lammers JW;van Ginneken B;Prokop M;de Jong PA
通讯作者：
de Jong PA
影响因子：
9.6
作者：
Busacker A;Newell JD Jr;Keefe T;Hoffman EA;Granroth JC;Castro M;Fain S;Wenzel S
通讯作者：
Wenzel S