Identification of Occult Parechymal Disease Such as Emphysema or Airway Disease Using Screening Computed Tomography
Identification of Occult Parechymal Disease Such as Emphysema or Airway Disease Using Screening Computed Tomography
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DOI：
10.3109/15412551003631717
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发表时间：
2010-04-01
影响因子：
2.2
通讯作者：
Fukuhara, Shunichi
中科院分区：
文献类型：
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作者：
Tsushima, Kenji;Sone, Shusuke;Fukuhara, Shunichi
理由：慢性阻塞性肺疾病（COPD）是一个主要的公共卫生问题。本研究旨在确定低剂量计算机断层扫描（CT）提供的低衰减面积（LAA）和视觉评分是否可用于检测隐匿性实质疾病，如隐匿性COPD。方法：所有受试者均接受低剂量CT扫描和肺功能检查。计算相应肺面积的LAA%。正常肺密度面积和LAA之间的截止水平定义为-960 HU，肺气肿变化的严重程度（视觉评分）和LAA%在完全吸气时获得的三个相同的胸部CT切片上进行评价。结果：2,247人中有48人（包括1058名非吸烟者和1189名吸烟者）被诊断为COPD。诊断为COPD的个体的胸部CT结果显示小叶中心型肺气肿（50%），然而，17例诊断为COPD的受试者的筛查CT结果正常。31例诊断为COPD的受试者显示出阳性视觉评分，27例COPD患者显示LAA%大于30。9/17例视觉评分为阴性的受试者显示LAA%超过30。吸烟者的视觉评分显著高于非吸烟者。吸烟者肺功能低于非吸烟者。吸烟者胸部CT异常的频率也较高。结论：低剂量CT扫描检测LAA和积极的视觉评分之前，COPD与肺功能受损的发展。肺功能正常的吸烟者有可能发展为气流阻塞伴异常CT结果。
Rationale: Chronic obstructive pulmonary disease (COPD) is a major public health problem. This study was performed to determine whether the low attenuation area (LAA) and visual score provided by low-dose computed tomography (CT) can be used to detect occult parenchymal disease, such as insidious COPD. Methods: Each participant underwent low-dose CT scan and pulmonary function tests. The LAA% of the corresponding lung area was calculated. The cut-off level between the normal lung density area and LAA was defined as -960 HU, and the severity of emphysematous change (visual score) and LAA% were evaluated on three same chest CT slices obtained at full inspiration. Results: Forty-eight of 2,247 individuals including 1058 non-smokers and 1189 smokers were diagnosed with COPD. Chest CT findings in individuals diagnosed with COPD showed centrilobular emphysema (50%), however, 17 of the subjects diagnosed with COPD had normal screening CT findings. Thirty-one subjects diagnosed with COPD showed a positive visual score, and 27 individuals with COPD showed LAA% of more than 30. Nine of 17 subjects with a negative visual score showed LAA% of more than 30. The visual score in smokers was significantly higher than that of non-smokers. The lung function in smokers was lower than that of non-smokers. Smokers also showed higher frequencies of chest CT abnormalities. Conclusion: Low-dose CT scans detected LAA and a positive visual score before COPD associated with an impaired lung function develops. Smokers with normal spirometry had a potential to develop an airflow obstruction accompanied with abnormal CT findings.