Systems for lung volume standardization during static and dynamic MDCT-based quantitative assessment of pulmonary structure and function.
Systems for lung volume standardization during static and dynamic MDCT-based quantitative assessment of pulmonary structure and function.
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DOI：
10.1016/j.acra.2012.03.017
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发表时间：
2012-08
影响因子：
4.8
通讯作者：
Hoffman, Eric A.
中科院分区：
文献类型：
--
作者：
Fuld, Matthew K.;Grout, Randall W.;Guo, Junfeng;Morgan, John H.;Hoffman, Eric A.
多排计算机断层扫描（MDCT）已成为定量评估慢性阻塞性肺疾病（COPD）和哮喘患者实质破坏、空气滞留（密度指标）和气道重塑（与气道壁和管腔几何形状相关的指标）的工具。这些MDCT衍生指标的准确性和可解释性的关键是确保在屏气期间以标准化体积扫描肺部。开发了一种计算机监控的涡轮流量计系统，以控制患者屏气并促进固定肺活量百分比的静态成像。由于在多呼吸氙气CT期间气体密度变化的校准挑战，需要替代系统。该设计采用双滚动密封活塞。这两种系统都在实验室环境和人体试验中进行了测试。基于涡轮机的系统成功控制了32/37例受试者的肺容量，重复扫描之间的CT测量空气容量具有线性关系：对于所有扫描，差异（扫描1-扫描2）的平均值和置信区间为−9 ml（−169，151）;对于单独TLC，为6 ml（−164，177）;对于单独FRC，为−23 ml（−172，126）。双活塞系统成功控制了31/41例受试者的肺容量。研究失败主要与受试者不遵守口头指示和吸嘴周围气体泄漏有关。我们证明了成功使用涡轮为基础的系统静态肺容量控制，并证明其不足之处，动态氙CT研究。双滚动密封肺量计的实施已被证明可以充分控制多呼吸洗入氙CT研究的肺容量。这些系统与适当的患者指导相结合，为使用CT定量局部肺结构和功能提供了工具。用于评估局部肺功能的洗入式氙-CT方法虽然不一定适用于常规临床研究，但提供了一种动态方案，可以根据该方案验证新出现的单次呼吸、双能量氙-CT测量。
Multidetector-row Computed Tomography (MDCT) has emerged as a tool for quantitative assessment of parenchymal destruction, air trapping (density metrics) and airway remodeling (metrics relating airway wall and lumen geometry) in chronic obstructive pulmonary disease (COPD) and asthma. Critical to the accuracy and interpretability of these MDCT-derived metrics is the assurance that the lungs are scanned during a breath-hold at a standardized volume. A computer monitored turbine-based flow meter system was developed to control patient breath-holds and facilitate static imaging at fixed percentages of the vital capacity. Due to calibration challenges with gas density changes during multi-breath xenon-CT an alternative system was required. The design incorporated dual rolling seal pistons. Both systems were tested in a laboratory environment and human subject trials. The turbine-based system successfully controlled lung volumes in 32/37 subjects, having a linear relationship for CT measured air volume between repeated scans: for all scans, the mean and confidence interval of the differences (scan1-scan2) was −9 ml (−169, 151); for TLC alone 6 ml (−164, 177); for FRC alone, −23 ml (−172, 126). The dual-piston system successfully controlled lung volume in 31/41 subjects. Study failures related largely to subject non-compliance with verbal instruction and gas leaks around the mouthpiece. We demonstrate the successful use of a turbine-based system for static lung volume control and demonstrate its inadequacies for dynamic xenon-CT studies. Implementation of a dual-rolling seal spirometer has been shown to adequately control lung volume for multi-breath wash-in xenon-CT studies. These systems coupled with proper patient coaching provide the tools for the use of CT to quantitate regional lung structure and function. The wash-in xenon-CT method for assessing regional lung function, while not necessarily practical for routine clinical studies, provides for a dynamic protocol against which newly emerging single breath, dual-energy xenon-CT measures can be validated.
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影响因子：
3.3
作者：
MILICEMILI, J;HENDERSON, JA;KANEKO, K
通讯作者：
KANEKO, K
影响因子：
3.3
作者：
Lynch, David A.;Newell, John D.
通讯作者：
Newell, John D.
DOI：
10.1513/pats.200509-099ds
发表时间：
2005-01-01
期刊：
Proceedings of the American Thoracic Society
影响因子：
--
作者：
Hoffman, Eric A;Chon, Deokiee
通讯作者：
Chon, Deokiee
影响因子：
9.6
作者：
Camiciottoli, G;Bartolucci, M;Pistolesi, M
通讯作者：
Pistolesi, M
影响因子：
24.3
作者：
Miller, MR;Hankinson, J;Wanger, J
通讯作者：
Wanger, J