Stolk J, Versteegh M I M, Montenij L J, Bakker M E, Grebski E, Tutic M, Wildermuth S, Weder W, el Bardiji M, Reiber J H C, Rabe K F, Russi E W, Stoel B C
Department of Pulmonology (C3-P), Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands, and Department of Radiology, University Hospital Zurich, Switzerland.
Eur Respir J. 2007 Jun;29(6):1138-43. doi: 10.1183/09031936.00056206. Epub 2007 Mar 1.
To explore if change in the extent of emphysema correlated with change in lung function, the effect of resection of emphysematous tissue was studied by computed tomography (CT) densitometry. In addition, the current authors studied how surgery-induced change in emphysema related to lung density in control subjects. In total, 30 patients (14 females; mean+/-sd age 59+/-10 yrs) with severe emphysema before and 3 months after lung volume reduction surgery (LVRS), 48 patients with moderate emphysema and 76 control subjects were investigated. Lung density (15th percentile point) of both lungs and heterogeneity of lung density between 12 isovolumetric partitions in each lung were calculated from chest CT images. The 15th percentile point and its heterogeneity could distinguish controls from subjects with moderate emphysema with a sensitivity and specificity of >95%. LVRS significantly increased lung density by 5.0+/-10.9 g.L(-1) (n=30). Improvement in the diffusing capacity of the lung for carbon monoxide and in residual volume significantly correlated with an increase in lung density (n=20 and 28, respectively). Change in forced expiratory volume in one second did not correlate with change in lung density. In conclusion, lung density 15th percentile point is a valuable surrogate marker for detection of both the extent of and reduction in emphysema.
为探究肺气肿程度的变化是否与肺功能变化相关，通过计算机断层扫描（CT）密度测定法研究了肺气肿组织切除的效果。此外，本研究作者还研究了手术引起的肺气肿变化与对照受试者肺密度的关系。总共对30例（14例女性；平均±标准差年龄59±10岁）重度肺气肿患者在肺减容手术（LVRS）前及术后3个月、48例中度肺气肿患者和76例对照受试者进行了调查。根据胸部CT图像计算双肺的肺密度（第15百分位数）以及每侧肺12个等容积分区之间肺密度的异质性。第15百分位数及其异质性能够以>95%的敏感性和特异性区分对照者与中度肺气肿受试者。LVRS使肺密度显著增加5.0±10.9 g·L⁻¹（n = 30）。肺一氧化碳弥散量和残气量的改善与肺密度增加显著相关（分别为n = 20和28）。一秒用力呼气量的变化与肺密度变化不相关。总之，肺密度第15百分位数是检测肺气肿程度及其减轻情况的有价值替代指标。
