Quantitative assessment of multiscale structural and functional alterations in asthmatic populations
Quantitative assessment of multiscale structural and functional alterations in asthmatic populations
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DOI：
10.1152/japplphysiol.01094.2014
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发表时间：
2015-05-15
影响因子：
3.3
通讯作者：
Lin, Ching-Long
中科院分区：
文献类型：
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作者：
Choi, Sanghun;Hoffman, Eric A.;Lin, Ching-Long
在局部和整体（或肺叶）水平上哮喘肺的结构和功能变量之间的关系仍有待发现。本研究旨在研究哮喘受试者结构变量[分叉角、圆形度、气道壁厚度（WT）和水力直径（D-h）]的局部变化，以及它们与其他基于成像和肺功能测试的整体和肺叶指标（包括肺形状、空气滞留、局部体积变化等）的相关性。61名健康受试者，67名非重度和67名重度哮喘受试者进行了研究。结构变量来源于总肺容量（TLC）的计算机断层扫描图像。在功能残气量下测量空气滞留，并在功能残气量和TLC之间测量区域体积变化（来自图像配准）。用61例健康人的气管直径和WT预测Dh和WT。新的标准化方案允许分离管腔狭窄和管壁增厚效应。在重度哮喘患者中，发现分叉角度的改变与TLC的球形肺形状相关，右主支气管的圆形度显著降低。虽然标准化WT增加，特别是在严重哮喘受试者的上叶，标准化Dh下降，在下叶。在局部结构变量中，标准化Dh是最具代表性的变量，因为它与功能变量（包括肺功能检查数据）的变化显著相关。总之，了解多尺度现象可能有助于提供指导，在寻找潜在的成像为基础的表型的发展和疗效评估的治疗干预。
Relationships between structural and functional variables in asthmatic lungs at local and global (or lobar) levels remain to be discovered. This study aims to investigate local alterations of structural variables [bifurcation angle, circularity, airway wall thickness (WT), and hydraulic diameter (D-h)] in asthmatic subjects, and their correlations with other imaging and pulmonary function test-based global and lobar metrics, including lung shape, air-trapping, regional volume change, and more. Sixty-one healthy subjects, and 67 nonsevere and 67 severe asthmatic subjects were studied. The structural variables were derived from computed tomography images at total lung capacity (TLC). Air-trapping was measured at functional residual capacity, and regional volume change (derived from image registration) was measured between functional residual capacity and TLC. The tracheal diameter and WT predicted by 61 healthy subjects were used to normalize the Dh and WT. New normalization schemes allowed for the dissociation of luminal narrowing and wall thickening effects. In severe asthmatic subjects, the alteration of bifurcation angle was found to be correlated with a global lung shape at TLC, and circularity was significantly decreased in the right main bronchus. While normalized WT increased especially in the upper lobes of severe asthmatic subjects, normalized Dh decreased in the lower lobes. Among local structural variables, normalized Dh was the most representative variable, because it was significantly correlated with alterations of functional variables, including pulmonary function test's data. In conclusion, understanding multiscale phenomena may help to provide guidance in the search for potential imaging-based phenotypes for the development and outcomes assessment of therapeutic intervention.