REGIONAL STRUCTURE-FUNCTION CORRELATIONS IN CHRONIC OBSTRUCTIVE LUNG-DISEASE MEASURED WITH POSITRON EMISSION TOMOGRAPHY
REGIONAL STRUCTURE-FUNCTION CORRELATIONS IN CHRONIC OBSTRUCTIVE LUNG-DISEASE MEASURED WITH POSITRON EMISSION TOMOGRAPHY
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DOI：
10.1136/thx.47.11.914
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发表时间：
1992-11-01
期刊：
影响因子：
10
通讯作者：
HUGHES, JMB
中科院分区：
文献类型：
--
作者：
BRUDIN, LH;RHODES, CG;HUGHES, JMB
背景正电子发射断层扫描半衰期极短，可用于确定局部肺组织密度与局部通气量及通气量/灌注率之间的关系。该方法应用于10例慢性重度气流阻塞患者，其一氧化碳转移因子(TLCO)和传递系数(KCO)值不同。方法对仰卧位患者在心脏正中水平的单个横断面上局部测量通气量(VA)、通气量/灌注率(V/Q)、肺密度和血容量。计算肺泡体积、血管外组织肺密度和灌注量(Q)。结果组织密度与Q/Q比值呈负相关(r=0.55)，与Q值呈正相关(r=0.59)，与血容量呈正相关(r=0.65)。在4例低一氧化碳转移因子(TLCO)和转移系数(KCO)的患者中，50%预测许多低VA区的组织密度低，V/Q正常或高。另一方面，在4例TLCO和KCO>；50%的患者中，预测许多低VA区的组织密度正常或高，V/Q值低。组织密度均值与V/Q的个体比值与KCO呈正相关(%pred；r=0.79)。结论这些发现将结构差异与不同的功能类型联系起来；它们强化了这样的观点，即一些慢性气流阻塞患者以支气管炎或水肿为主，而另一些患者则以肺泡破坏为主要特征。
Background Positron emission tomography, performed with isotopes of very short half life, can be used to relate local lung tissue density to local ventilation and to the ventilation:perfusion ratio. This method has been used in 10 patients with severe chronic airflow obstruction and differing values for carbon monoxide transfer factor (TLCO) and transfer coefficient (KCO).Methods Ventilation (VA) and the ventilation: perfusion ratio (V/Q), lung density, and blood volume were measured regionally in a single transaxial section at mid-heart level with the patients in a supine position. Alveolar volume, extravascular tissue lung density, and perfusion (Q) were derived. Twenty five regions with abnormalities in the ventilation images were analysed.Results Tissue density showed a negative correlation with the ratio Q/Q (r - 0.55) and a positive correlation with Q (r = 0.59) and blood volume(r = 0.65). In four patients with a low carbon monoxide transfer factor (TLCO) and transfer coefficient (KCO) < 50% predicted many regions with low VA had low tissue density and normal or high V/Q. On the other hand, in four patients with TLCO and KCO > 50% predicted many regions with low VA had normal or high tissue density and low values of V/Q. The other two patients had patterns between these two extremes. Individual ratios between mean values of tissue density and V/Q had a positive correlation with KCO (% pred; r = 0.79).Conclusions These findings link structural differences with distinctive functional patterns; they reinforce the view that bronchial inflammation or oedema predominate in some patients with chronic airflow obstruction, whereas alveolar destruction is the major feature in others.