Quantitative assessment of the airway wall using computed tomography and optical coherence tomography.
Quantitative assessment of the airway wall using computed tomography and optical coherence tomography.
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DOI：
10.1513/pats.200904-015aw
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发表时间：
2009-08-15
期刊：
影响因子：
--
通讯作者：
Lam, Stephen
中科院分区：
文献类型：
--
作者：
Coxson, Harvey O;Lam, Stephen
自从Hogg、Thurlbeck和Macklem描述了慢性阻塞性肺疾病气流阻塞的部位和性质以来，研究人员一直在寻找无创测量气道壁尺寸的方法。计算机断层扫描技术和新的计算机算法的最新进展使得在不需要组织的情况下可视化和测量气道壁和管腔成为可能。然而，虽然对气道的计算机断层扫描评估有很大的希望，但众所周知的是，空间分辨率不允许小气道可视化，并且仍然存在对从这些气道获得的这些测量的灵敏度的担忧。光学相干断层扫描是一种新的支气管镜成像技术，由于其空间分辨率远高于计算机断层扫描，引起了人们的极大兴趣。虽然比计算机断层扫描相对更具侵入性，但它具有不使患者暴露于电离辐射的优点。这篇综述讨论了慢性阻塞性肺疾病患者这两种成像技术的一些数据。这些成像技术在慢性阻塞性肺疾病患者的评估中非常重要，因为设计用于调节气道炎症的治疗可能在具有肺气肿表型的受试者中是禁忌的，反之亦然。因此，这些新的成像技术很可能在慢性阻塞性肺疾病的研究中发挥一线作用，并有望使临床医生能够对个体进行表型分析，从而使其治疗个性化。
Ever since the site and nature of airflow obstruction in chronic obstructive pulmonary disease was described by Hogg, Thurlbeck, and Macklem, investigators have been looking for methods to noninvasively measure the airway wall dimensions. Recent advances in computed tomography technology and new computer algorithms have made it possible to visualize and measure the airway wall and lumen without the need for tissue. However, while there is great hope for computed tomographic assessment of airways, it is well known that the spatial resolution does not allow small airways to be visualized and there are still concerns about the sensitivity of these measurements obtained from these airways. Optical coherence tomography is a new bronchoscopic imaging technique that has generated considerable interest because the spatial resolution is much higher than computed tomography. While relatively more invasive than computed tomography, it has the advantage of not exposing the patient to ionizing radiation. This review discusses some of the data surrounding these two imaging techniques in patients with chronic obstructive pulmonary disease. These imaging techniques are extremely important in the assessment of patients with chronic obstructive pulmonary disease because therapy that is designed to modulate the inflammation in airways may be contraindicated in subjects with the emphysema phenotype and visa versa. Therefore, these new imaging techniques are very likely to play a front-line role in the study of chronic obstructive pulmonary disease and will, hopefully, allow clinicians to phenotype individuals, thereby personalizing their treatment.