CT Diagnosis of Tracheomalacia in Patients with COPD

慢阻肺患者气管软化的CT诊断

• 批准号: 7842884
• 负责人: PHILLIP M BOISELLE
• 金额: $ 17.34万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7842884
• 关键词: Accounting; Anesthesia procedures; Animal Welfare; Bibliography; Bronchoscopy; Caring; Cartilage; Chronic; Chronic Obstructive Airway Disease; Clinical; Coughing; Country; Diagnosis; Diagnostic; Disease; Doctor of Philosophy; Environment; Environmental Impact; Equipment; Goals; Gold; IACUC; International; Intervention; Israel; Left; Medical; Medical center; Methods; Morbidity - disease rate; Natural History; Office Visits; Pathology; Patients; Persons; Physiological; Predictive Factor; Prevalence; Principal Investigator; Procedures; Pulmonology; Radiology Specialty; Research; Research Ethics Committees; Resources; Risk Factors; Role; Symptoms; Testing; Thoracic Surgical Procedures; Trachea; United States; Vertebrates; Work; abstracting; expiration; human subject; medical schools; multidisciplinary; novel; programs; pulmonary function; respiratory; response

The broad, long-term goals of the proposed study are to determine the prevalence and natural history of tracheomalacia among patients with chronic obstructive pulmonary disease (COPD) and to establish the role of a novel CT method in guiding therapy and assessing response to intervention. This work also has the potential to reduce morbidity among patients with coexisting COPD and tracheomalacia. Chronic cough is the fifth most common symptom for which patients seek medical care in the United States, accounting for more than 30 million office visits per year. Acquired tracheomalacia, a condition defined by excessive expiratory collapse of the trachea due to weakness of the airway walls and/or supporting cartilage, is a relatively common but frequently overlooked cause of chronic cough. Tracheomalacia is associated with a variety of risk factors, most notably COPD. Importantly, tracheomalacia can cause significant respiratory morbidity if left untreated, and it may rarely be fatal. Our preliminary studies demonstrate that paired inspiratory-dynamic expiratory CT is a highly accurate, noninvasive method for diagnosing tracheomalacia, with comparable accuracy to the current gold standard of bronchoscopy, an invasive procedure. We propose a diagnostic study which will be a collaborative, multidisciplinary effort by the departments of radiology, pulmonary medicine, thoracic surgery, pathology, and anesthesia at Beth Israel Deaconess Medical Center and Harvard Medical School, a center that has established expertise in the diagnosis and treatment of this disorder. We propose the following specific aims: Aim 1: Determine the prevalence of tracheomalacia among patients with COPD; Aim 2: Identify physiological and clinical parameters that are predictive of tracheomalacia in patients with COPD; Aim 3: Determine the natural history of tracheomalacia in the absence of intervention among subjects who are asymptomatic or mildly symptomatic; and Aim 4: Identify factors that are predictive of a positive response to intervention by assessing longitudinal changes in key parameters among severely symptomatic participants following therapy. The import of the proposed study is two-fold: 1) it will noninvasively determine the prevalence and natural history of tracheomalacia among patients with COPD; and 2) it has the potential to reduce morbidity among patients with coexisting COPD and tracheomalacia. Narrative: Acquired tracheomalacia, a condition defined by excessive expiratory collapse of the trachea due to weakness of the airway walls and/or supporting cartilage, is a common but often overlooked cause of chronic respiratory symptoms that is associated with a variety of risk factors, most notably chronic obstructive pulmonary disease (COPD). The broad, long-term goals of the proposed study are to determine the prevalence and natural history of tracheomalacia among patients with COPD and to establish the role of a novel CT method in guiding therapy and assessing response to intervention. This work also has the potential to reduce morbidity among patients with coexisting COPD and tracheomalacia.

这项拟议研究的长期目标是确定慢性阻塞性肺疾病(COPD)患者中气管软化的患病率和自然病史，并确定一种新的CT方法在指导治疗和评估干预反应方面的作用。这项工作也有可能减少COPD和气管软化并存患者的发病率。在美国，慢性咳嗽是患者就医的第五大常见症状，每年就诊人数超过3000万。获得性气管软化症是一种相对常见但经常被忽视的慢性咳嗽原因，其定义是由于气道壁和/或支撑软骨的薄弱导致气管过度呼气塌陷。气管软化与多种危险因素有关，尤其是慢性阻塞性肺疾病。重要的是，如果不治疗，气管软化会导致严重的呼吸道疾病，而且很少是致命的。我们的初步研究表明，成对的吸气-呼气CT是一种诊断气管软化的高精度、非侵入性方法，其准确性与目前支气管镜检查的金标准相当，后者是一种有创的检查方法。我们提出了一项诊断性研究，这将是贝丝以色列女执事医学中心和哈佛医学院放射科、肺部内科、胸科外科、病理学和麻醉科的多学科合作努力，该中心在这种疾病的诊断和治疗方面已经建立了专业知识。我们提出以下具体目标：目标1：确定COPD患者中气管软化的患病率；目标2：确定预测COPD患者气管软化的生理和临床参数；目标3：在无症状或轻度症状的受试者中确定气管软化的自然病史；以及目标4：通过评估治疗后有严重症状的参与者关键参数的纵向变化，确定对干预有积极反应的因素。这项拟议的研究有两方面的意义：1)它将非侵入性地确定COPD患者中气管软化的患病率和自然病史；2)它有可能降低COPD和气管软化并存患者的发病率。简介：获得性气管软化是一种常见但经常被忽视的原因，与各种危险因素有关，最明显的是慢性阻塞性肺疾病(COPD)。获得性气管软化是一种由气道壁和/或支撑软骨薄弱导致的气管过度呼气塌陷的状况。这项拟议研究的广泛、长期目标是确定COPD患者中气管软化的患病率和自然病史，并确定一种新的CT方法在指导治疗和评估干预反应方面的作用。这项工作也有可能减少COPD和气管软化并存患者的发病率。