Relationships between airflow obstruction and quantitative CT measurements of emphysema, air trapping, and airways in subjects with and without chronic obstructive pulmonary disease.
Relationships between airflow obstruction and quantitative CT measurements of emphysema, air trapping, and airways in subjects with and without chronic obstructive pulmonary disease.
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有或没有慢性阻塞性肺部疾病的受试者中气流阻塞与肺气肿，空气陷阱和气道的定量CT测量之间的关系。
DOI：
10.2214/ajr.12.10102
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发表时间：
2013-09
期刊：
影响因子：
--
通讯作者：
Lynch DA
中科院分区：
文献类型：
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作者：
Schroeder JD;McKenzie AS;Zach JA;Wilson CG;Curran-Everett D;Stinson DS;Newell JD Jr;Lynch DA
本研究评价了定量CT（QCT）和肺功能测定法测量吸烟者伴和不伴慢性阻塞性肺疾病（COPD）的疾病严重程度之间的关系。对COPD遗传流行病学（COPDGene）研究中4062例受试者的吸气和呼气CT扫描进行了评价。检查的指标包括肺气肿，定义为吸气CT上低衰减区域≤ −950 HU的百分比，我们称之为“LAA-950 I”;空气滞留，定义为呼气CT上低衰减区域≤ −856 HU的百分比，我们称之为“LAA-856 E”;以及节段和亚节段气道的10 mm内周长的假设气道的内径、内面积和外面积、壁面积、气道壁厚度和壁面积的平方根。使用统计软件（SAS，版本9.2）确定肺功能测定和几个QCT测量之间的相关性。低衰减区的QCT测量值与肺量测定法具有强烈且显著的相关性（p < 0.0001）。LAA-856 E与1秒用力呼气量（FEV 1）和FEV 1与用力肺活量（FVC）比值的相关性（分别为r =-0.77和-0.84）强于LAA-950 I与FEV 1和FEV 1/FVC的相关性（r =-0.67和r =-0.76）。根据慢性阻塞性肺疾病全球倡议（GOLD）分期系统的测量，随着疾病严重程度的增加，吸气量和呼气量的变化减少（p < 0.0001）。当气道变量与低衰减面积测量值一起纳入多元回归模型时，该模型在统计学上占FEV 1和FEV 1/FVC变异的比例更大（R2分别为0.72和0.77）。单独的气道测量与肺功能测定FEV 1（r = 0.15至-0.44）和FEV 1/FVC（r = 0.19至-0.34）的相关性较小。QCT测量与肺功能测定结果密切相关，显示吸烟者的损害。LAA-856 E与气道阻塞的生理学测量结果密切相关。气道测量可与低衰减区域的QCT测量同时使用，以准确预测肺功能。
This study evaluates the relationships between quantitative CT (QCT) and spirometric measurements of disease severity in cigarette smokers with and without chronic obstructive pulmonary disease (COPD). Inspiratory and expiratory CT scans of 4062 subjects in the Genetic Epidemiology of COPD (COPDGene) Study were evaluated. Measures examined included emphysema, defined as the percentage of low-attenuation areas ≤ −950 HU on inspiratory CT, which we refer to as “LAA-950I”; air trapping, defined as the percentage of low-attenuation areas ≤ −856 HU on expiratory CT, which we refer to as “LAA-856E”; and the inner diameter, inner and outer areas, wall area, airway wall thickness, and square root of the wall area of a hypothetical airway of 10-mm internal perimeter of segmental and subsegmental airways. Correlations were determined between spirometry and several QCT measures using statistics software (SAS, version 9.2). QCT measurements of low-attenuation areas correlate strongly and significantly (p < 0.0001) with spirometry. The correlation between LAA-856E and forced expiratory volume in 1 second (FEV1) and the ratio of FEV1 to forced vital capacity (FVC) (r = −0.77 and −0.84, respectively) is stronger than the correlation between LAA-950I and FEV1 and FEV1/FVC (r = −0.67 and r = −0.76). Inspiratory and expiratory volume changes decreased with increasing disease severity, as measured by the Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) staging system (p < 0.0001). When airway variables were included with low-attenuation area measures in a multiple regression model, the model accounted for a statistically greater proportion of variation in FEV1 and FEV1/FVC (R2 = 0.72 and 0.77, respectively). Airway measurements alone are less correlated with spirometric measures of FEV1 (r = 0.15 to −0.44) and FEV1/FVC (r = 0.19 to −0.34). QCT measurements are strongly associated with spirometric results showing impairment in smokers. LAA-856E strongly correlates with physiologic measurements of airway obstruction. Airway measurements can be used concurrently with QCT measures of low-attenuation areas to accurately predict lung function.