Computed Tomographic Imaging of the Airways in COPD and Asthma
Computed Tomographic Imaging of the Airways in COPD and Asthma
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DOI：
10.1097/rti.0b013e3182277113
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发表时间：
2011-11-01
影响因子：
3.3
通讯作者：
Ley-Zaporozhan, Julia
中科院分区：
文献类型：
--
作者：
Kauczor, Hans-Ulrich;Wielpuetz, Mark O.;Ley-Zaporozhan, Julia
计算机断层扫描 (CT) 是气道成像的首选方式。应使用基于具有重叠重建的多探测器薄层 CT 的具有各向同性空间分辨率的体积数据集。慢性阻塞性肺病和哮喘是两种最常见的由气流阻塞定义的疾病。气道变化的形态学相关因素包括管腔扩张、管壁增厚、粘液或水肿导致的小气道可见度、空气滞留、缺氧血管收缩和塌陷。为了评估空气滞留，建议进行额外的呼气低剂量扫描。在临床常规中，这些结果通过目视评估并应定期报告。然而，观察者之间的变异性很高，显然需要基于软件的客观测量。此类工具的开发具有挑战性，而且它们刚刚在更广泛的范围内变得可用。基于双能 CT 的新技术旨在测量碘分布图以评估肺灌注以及吸入氙气的分布以评估肺通气的分布和时程。然而，这些技术仍在临床研究中进行研究。本综述将概述 CT 在慢性阻塞性肺病和哮喘诊断中的作用、其在这些疾病表型分析中的作用以及疾病严重程度和功能损害的测量。
Computed tomography (CT) is the modality of choice for imaging the airways. Volumetric data sets with isotropic spatial resolution based on multidetector thin-section CT with overlapping reconstruction should be used. Chronic obstructive pulmonary disease and asthma are the 2 most common disease entities that are defined by airflow obstruction. The morphologic correlates of airway changes are dilation of the lumen, thickening of the wall, visibility of small airways due to mucus or edema, air trapping, hypoxic vasoconstriction, and collapsibility. To assess air trapping, additional expiratory low-dose scans are recommended. In clinical routine, these findings are visually assessed and should be routinely reported. However, the interobserver variability is high, and there is a clear need for objective software-based measurements. The development of such tools is challenging, and they are just becoming available on a broader scale. Novel techniques based on dual-energy CT aim to measure iodine distribution maps to assess pulmonary perfusion as well as the distribution of inhaled xenon gas to assess the distribution and time course of pulmonary ventilation. However, these techniques are still being investigated in clinical studies. This review will provide an overview of CT for the diagnosis of chronic obstructive pulmonary disease and asthma, its role in phenotyping these diseases, and the measurement of disease severity and functional compromise.