Lobar analysis of collapsibility indices to assess functional lung volumes in COPD patients.
Lobar analysis of collapsibility indices to assess functional lung volumes in COPD patients.
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DOI：
10.2147/copd.s72616
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发表时间：
2014
影响因子：
2.8
通讯作者：
Naganawa S
中科院分区：
文献类型：
--
作者：
Kitano M;Iwano S;Hashimoto N;Matsuo K;Hasegawa Y;Naganawa S
我们使用成对的吸气和呼气三维（3D）计算机断层扫描（CT）图像，研究了慢性阻塞性肺疾病（COPD）患者肺容量指数和肺功能测试（PFT）结果之间的相关性，并评估了肺叶差异。我们回顾性评估了28例COPD患者，他们在同一天进行了成对的吸气和呼气CT和PFT检查。计算机辅助诊断系统计算总肺叶体积和肺气肿肺叶体积（ELV）。通过从吸气相（NLVI）和呼气相（NLVE）的总肺叶容积中减去ELV来确定正常肺叶容积（NLV）。我们还确定了肺叶可吸收性指数：NLV可吸收性比率（NLVCR）（%）=（1 − NLVE/NLVI）× 100%。通过Pearson相关分析确定肺叶体积和PFT结果之间的关系，以及可扩展性指数和PFT结果之间的关系。NLVCR值与PFT结果显著相关。1秒用力呼气量占预计值的百分比（FEV1%P）与下叶NLVCR值显著相关（P<0.01），而上叶的相关性不显著（P=0.05）。肺下叶FEV1%P与吸气、呼气ELV（ELVI，E）呈中度相关（P<0.05）。相反，一氧化碳弥散量与肺泡气体体积的比值（DLCO/VA%P）与肺上叶ELVI有很强的相关性（P<0.001），而与肺上叶NLVCR值的相关性较弱（P<0.01），与肺下叶无显著性（P=0.26）。FEV1%P结果与下叶的NLV舒张指数相关，而DLCO/VA%P结果与上叶的NLV舒张指数和ELV相关。因此，评估肺叶NLV的可接受性可能有助于评估COPD患者的肺功能。
We investigated correlations between lung volume collapsibility indices and pulmonary function test (PFT) results and assessed lobar differences in chronic obstructive pulmonary disease (COPD) patients, using paired inspiratory and expiratory three dimensional (3D) computed tomography (CT) images. We retrospectively assessed 28 COPD patients who underwent paired inspiratory and expiratory CT and PFT exams on the same day. A computer-aided diagnostic system calculated total lobar volume and emphysematous lobar volume (ELV). Normal lobar volume (NLV) was determined by subtracting ELV from total lobar volume, both for inspiratory phase (NLVI) and for expiratory phase (NLVE). We also determined lobar collapsibility indices: NLV collapsibility ratio (NLVCR) (%) = (1 − NLVE/NLVI) × 100%. Associations between lobar volumes and PFT results, and collapsibility indices and PFT results were determined by Pearson correlation analysis. NLVCR values were significantly correlated with PFT results. Forced expiratory volume in 1 second, measured as percent of predicted results (FEV1%P) was significantly correlated with NLVCR values for the lower lobes (P<0.01), whereas this correlation was not significant for the upper lobes (P=0.05). FEV1%P results were also moderately correlated with inspiratory, expiratory ELV (ELVI,E) for the lower lobes (P<0.05). In contrast, the ratio of the diffusion capacity for carbon monoxide to alveolar gas volume, measured as percent of predicted (DLCO/VA%P) results were strongly correlated with ELVI for the upper lobes (P<0.001), whereas this correlation with NLVCR values was weaker for upper lobes (P<0.01) and was not significant for the lower lobes (P=0.26). FEV1%P results were correlated with NLV collapsibility indices for lower lobes, whereas DLCO/VA%P results were correlated with NLV collapsibility indices and ELV for upper lobes. Thus, evaluating lobar NLV collapsibility might be useful for estimating pulmonary function in COPD patients.