Airflow limitation and airway dimensions in chronic obstructive pulmonary disease
Airflow limitation and airway dimensions in chronic obstructive pulmonary disease
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DOI：
10.1164/rccm.200601-037oc
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发表时间：
2006-06-15
影响因子：
24.7
通讯作者：
Nishimura, Masaharu
中科院分区：
文献类型：
--
作者：
Hasegawa, Masaru;Nasuhara, Yasuyuki;Nishimura, Masaharu
依据：慢性阻塞性肺疾病（COPD）的特征是肺气肿和/或气道狭窄引起的气流受限。CT已被广泛应用于肺气肿的严重程度的评估，但很少有人关注使用CT评估气道疾病。目的：获得纵向图像和准确地分析位于肺内任何地方的内径>= 2 mm的气道的短轴图像与新的软件测量气道尺寸使用弯曲的多平面重建。方法：52例临床稳定的COPD患者（I期，14; II期，22; III期，14;第四阶段，2），利用软件分析了气流限制指数与气流速度的关系，（FEV1，%预测值）与右上叶第三代至第六代顶支气管（B1）和前基底支气管（88.右下叶。测量和主要结果：气道腔面积（Ai）和壁面积百分比（WA%）与FEV 1（%预测值）显著相关。更重要的是，相关系数（r）随着气道尺寸从第三组变小而提高。（节段性）至第六代，在两支气管中（Ai：81的r = 0.26、0.37、0.58和0.64; BB的r = 0.60、0.65、0.63和0.73）。结论：我们是第一个使用三维计算机断层扫描来证明COPD的气流限制与远端（小）气道的尺寸比近端（大）气道更密切相关。
Rationale: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and/or airway narrowing. Computed tomography has been widely used to assess emphysema severity, but less attention has been paid to the assessment of airway disease using computed tomography.Objectives: To obtain longitudinal images and accurately analyze short axis images of airways with an inner diameter >= 2 mm located anywhere in the lung with new software for measuring airway dimensions using curved multiplanar reconstruction.Methods: In 52 patients with clinically stable COPD (stage I, 14; stage II, 22; stage III, 14; stage IV, 2), we used the software to analyze the relationship of the airflow limitation index (FEV1, % predicted) with the airway dimensions from the third to the sixth generations of the apical bronchus (B1) of the right upper lobe and the anterior basal bronchus (88) of the right lower lobe. Measurements and Main Results: Airway luminal area (Ai) and wall area percent (WA%) were significantly correlated with FEV1 (% predicted). More importantly, the correlation coefficients (r) improved as the airways became smaller in size from the third (segmental) to sixth generations in both bronchi (Ai: r = 0.26, 0.37, 0.58, and 0.64 for 81; r = 0.60, 0.65, 0.63, and 0.73 for BB).Conclusions: We are the first to use three-dimensional computed tomography to demonstrate that airflow limitation in COPD is more closely related to the dimensions of the distal (small) airways than proximal (large) airways.