Direct evaluation of peripheral airways using ultra-high-resolution CT in chronic obstructive pulmonary disease
Direct evaluation of peripheral airways using ultra-high-resolution CT in chronic obstructive pulmonary disease
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DOI：
10.1016/j.ejrad.2019.108687
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发表时间：
2019-11-01
影响因子：
3.3
通讯作者：
Hirai, Toyohiro
中科院分区：
文献类型：
--
作者：
Tanabe, Naoya;Shima, Hiroshi;Hirai, Toyohiro
目的：直径 < 2 毫米的小气道疾病是慢性阻塞性肺病 (COPD) 的主要病理。然而，与直径<1mm的气道相比，直径1-2mm的气道的病理生理作用仍不清楚。本研究分析了体模和人体 COPD 数据，以检验超高分辨率计算机断层扫描 (U-HRCT) 可以准确测量传统 CT 难以测量的外周气道的假设。方法：使用体模管确定 U-HRCT 可测量的管腔尺寸下限。在 110 名接受 U-HRCT（1024 x 1024 矩阵，0.25 mm 切片厚度）和肺活量测定的男性 COPD 横断面数据中，对右心尖后支气管和基底后支气管（RB1 和 RB10）的所有第 3 代（节段性）至第 6 代气道（RB1 和 RB10）进行了分析。结果：体模管管腔面积 (LA) 测量误差 >=直径 1.3 和 1.0 毫米分别在 +/- 10 和-24% 范围内。 70% 和 62% 的第六代 RB1 和 RB10 气道的内径小于 2 毫米。随着气流受限严重程度的增加，第 6 代 RB1 和 RB10 气道的数量减少。在第3代至第6代气道的平均LA和LA总和(sum-LA)中，第6代的总LA对气流受限的影响最大。结论：U-HRCT可以准确、直接地评估直径1-2mm的周围气道。第六代气道的直径通常< 2 mm，sum-LA 可以成为反映 COPD 气流受限的有用 CT 生物标志物。
Purpose: Disease in small airways < 2 mm in diameter is a major pathology of chronic obstructive pulmonary disease (COPD). However, compared to airways < 1 mm in diameter, the pathophysiological role of airways 1-2mm in diameter remains unclear. This study analysed phantom and human COPD data to test the hypothesis that ultra-high-resolution computed tomography (U-HRCT) can accurately measure peripheral airways that are difficult to measure with conventional CT.Method: The lower limit of lumen sizes measurable on U-HRCT was determined using phantom tubes. In the cross-sectional data of 110 males with COPD who underwent U-HRCT (1024 x 1024 matrix, 0.25 mm slice thickness) and spirometry, all 3rd (segmental) to 6th generation airways of the right apical and basal posterior bronchus (RB1 and RB10) were analysed.Results: The errors in measuring the lumen area (LA) of phantom tubes >= 1.3 and 1.0 mm in diameter were within +/- 10 and-24%, respectively. The internal diameters for 70 and 62% of the 6th generation RB1 and RB10 airways were < 2 mm. The numbers of 6th generation RB1 and RB10 airways decreased as the airflow limitation severity increased. Among the mean LA and sum of LA(sum-LA) of the 3rd to 6th generation airways, the sum-LA of the 6th generation had the largest impact on airflow limitation.Conclusions: U-HRCT enables accurate and direct evaluation of peripheral airways 1-2mm in diameter. The 6th generation airways are commonly < 2 mm in diameter, and the sum-LA can be a useful CT biomarker that reflects airflow limitation in COPD.