Advances in Chronic Obstructive Pulmonary Disease Imaging.
Advances in Chronic Obstructive Pulmonary Disease Imaging.
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DOI：
10.23866/brnrev:2019-0023
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发表时间：
2020-05
期刊：
影响因子：
--
通讯作者：
Diaz AA
中科院分区：
文献类型：
--
作者：
Dolliver WR;Diaz AA
胸部计算机断层扫描（CT）成像是一个有用的工具，提供了在体内的信息，肺结构。成像有助于更好地了解COPD，允许检测早期结构变化和肺外结构的量化。新的CT成像技术提供了对主要COPD亚型（如肺气肿和小气道疾病）进展的深入了解。这篇文章作为一个审查的新信息相关的COPD成像。CT异常，如肺气肿和气道丧失，甚至存在于不符合COPD标准的吸烟者和轻中度疾病患者中。轻度至中度COPD受试者气道损失最严重，肺功能下降也最严重。COPD的肺外表现，如右心室扩大和CT测量的低肌肉质量，与全因死亡率的风险增加相关。CT纵向数据也可以深入了解COPD的进展。邻近肺气肿区域的肺实质机械性影响区域与FEV 1的更大下降相关。根据匹配的吸气-呼气CT扫描测量，具有最大百分比的小气道疾病的受试者也表现出肺功能的最大下降。
Chest computed tomography (CT) imaging is a useful tool that provides in vivo information regarding lung structure. Imaging has contributed to a better understanding of COPD, allowing for the detection of early structural changes and the quantification of extra-pulmonary structures. Novel CT imaging techniques have provided insight into the progression of the main COPD subtypes, such as emphysema and small airway disease. This article serves as a review of new information relevant to COPD imaging. CT abnormalities, such as emphysema and loss of airways, are present even in smokers who do not meet the criteria for COPD and in those with mild-to-moderate disease. Subjects with mild-to-moderate COPD, with the highest loss of airways, also experience the highest decline in lung function. Extra-pulmonary manifestations of COPD, such as right ventricle enlargement and low muscle mass measured on CT, are associated with increased risk for all-cause mortality. CT longitudinal data has also given insight into the progression of COPD. Mechanically affected areas of lung parenchyma adjacent to emphysematous areas are associated with a greater decline in FEV1. Subjects with the greatest percentage of small airway disease, as measured on matched inspiratory-expiratory CT scan, also present with the greatest decline in lung function.