Localization and Quantification of Regional and Segmental Air Trapping in Asthma
Localization and Quantification of Regional and Segmental Air Trapping in Asthma
复制标题
DOI：
10.1097/rct.0b013e31815f2bb0
复制
发表时间：
2008-07-01
影响因子：
1.3
通讯作者：
Oudkerk, Matthijs
中科院分区：
文献类型：
--
作者：
Cohen, Judith;Douma, W. Rob;Oudkerk, Matthijs
目的：评估体积和密度测量软件定位和量化哮喘中乙酰甲胆碱支气管激发后局部空气滞留迹象的可行性。方法：对 8 名仅使用短效 β(2) 激动剂且对乙酰甲胆碱具有高反应性的轻度至中度哮喘的特应性受试者进行了评估。获得乙酰甲胆碱支气管激发前后的低剂量基线呼气 16 层多探测器计算机断层扫描。 MeVisPULMO3D 软件（德国不来梅）应用于扫描，提供全肺和每个肺叶的体积和密度测量的定量信息。结果：乙酰甲胆碱后，呼气扫描显示体积中位数（四分位距）增加 534 mL（357-1279 mL），肺密度（平均值和第 15 个百分位数）减少 52 个 Hounsfield 单位 (HU) (116-39 HU) 和 34 HU (78-25 HU)，整个肺的低衰减区域百分比增加了 3% (2%-6%)，各个肺叶的模式相似。钻机和左下肺叶的空气滞留增加最大，分别为 211 mL (117-363 mL) 和 229 mL (15.5-315 mL)，而右上叶、中叶和左上叶的体积增加为 70 mL (20-249 mL)、26 mL (-16-92 mL) 和 91 mL (-28-241 mL)。分别。下叶的容量机会与用力肺活量 25% 至 75% 之间的基线用力呼气流量相关，而下叶的低衰减区域变化则不然。 结论：本研究表明，多排计算机断层扫描能够定位和量化乙酰甲胆碱支气管激发后哮喘中的区域空气滞留。与密度测量相比，肺叶的体积测量在检测肺部重力相关区域的局部空气滞留方面更优越。
Objective: To assess the feasibility of volumetric and densitometric software to localize and quantify signs of regional air trapping after methacholine bronchoprovocations in asthma.Methods: Eight atopic subjects with mild-to-moderate asthma using short-acting beta(2)-agonists only, with hyperresponsiveness to methacholine, were evaluated. Low-dose baseline expiratory 16-slice multidetector computed tomography scans before and after a methacholine bronchoprovocation were acquired. MeVisPULMO3D software (Bremen, Germany) was applied to the scans, providing quantitative information on volume and density measures of the total lung and each lobe.Results: After methacholine, the expiratory scan showed a median (interquartile range) increase in volume of 534 mL (357-1279 mL), a decrease in lung density (mean and 15th percentile) of 52 Hounsfield Units (HU) (116-39 HU) and 34 HU (78-25 HU), respectively, and an increase in percentage low attenuation areas of 3% (2%-6%) for the total lung, with similar patterns in individual lung lobes. The rig it and left lower lung lobes showed the largest increases in air trapping, 211 mL (117-363 mL) and 229 mL (15.5-315 mL), respectively, versus a volume increase of 70 mL (20-249 mL) 26 mL (-16-92 mL), and 91 mL (-28-241 mL) for the right upper, middle, and left upper lobes, respectively. Volume chances in the lower lobes were associated with baseline forced expiratory flow between 25% and 75% of forced vital capacity, whereas low attenuation areas changes in the lower lobes were not.Conclusions: This study suggests that multidetector computed tomography scans are able to localize and quantify regional air trapping in asthma after methacholine bronchoprovocations. Volumetric measurements of the lobes as compared to densitometric measurements are superior in detecting local air trapping in gravity-dependent areas of the lung.