Bankier Alexander A, Mehrain Sheida, Kienzl Daniela, Weber Michael, Estenne Marc, Gevenois Pierre Alain
Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215, USA.
Radiology. 2008 Jun;247(3):862-70. doi: 10.1148/radiol.2473071228. Epub 2008 Mar 28.
To prospectively determine whether the regional distribution of air trapping in patients with suspected or overt bronchiolitis is heterogeneous, and to determine the effect that a simulated reduction of computed tomographic (CT) sections and of scanned anatomic regions would have on the assessment of the extent of air trapping.
For this Ethical Committee-approved study, multi-detector row CT (collimation, 4 x 1 mm; rotation time, 0.5 second; 140 kVp; and 80 effective mAs) was performed in 47 lung transplant recipients (23 women, 24 men; mean age, 41 years +/- 12 [standard deviation]; 18 without bronchiolitis, 18 with potential bronchiolitis, and 11 with bronchiolitis, as determined by lung function measurements). Images were reconstructed with a thickness of 1 mm at an increment of 10 mm. The extent of air trapping in the upper, middle, and lower lung regions was correlated. Differences between regions and the interaction between patients and regions were tested with an analysis of variance. The extent of air trapping was calculated for six simulated examination protocols.
Correlations between the upper and middle (r = 0.930), the upper and lower (r = 0.756), and the middle and lower lung regions (r = 0.863) were significant (P < .001). The extent of air trapping increased from the upper to the lower lung region, with significant differences between regions (P < .001). There was a significant interaction between patients and lung regions (P < .001). Simulated examination protocols resulted in significantly different extents of air trapping (P < .001).
The regional distribution of the extent of air trapping in suspected or overt bronchiolitis is heterogeneous. Because the extent of air trapping can depend on the examination protocol, identical protocols are needed when air trapping is being compared within and between patients.
前瞻性地确定疑似或确诊细支气管炎患者气体陷闭的区域分布是否存在异质性，并确定模拟减少计算机断层扫描（CT）层面和扫描解剖区域对气体陷闭范围评估的影响。
在本项经伦理委员会批准的研究中，对47例肺移植受者（23例女性，24例男性；平均年龄41岁±12岁[标准差]；根据肺功能测量结果，18例无细支气管炎，18例有潜在细支气管炎，11例有细支气管炎）进行了多排探测器CT检查（准直，4×1mm；旋转时间，0.5秒；140kVp；有效管电流80mAs）。图像以1mm的层厚、10mm的层间距进行重建。对上、中、下肺区域的气体陷闭范围进行相关性分析。采用方差分析检验区域间差异以及患者与区域间的交互作用。针对六种模拟检查方案计算气体陷闭范围。
上肺与中肺（r = 0.930）、上肺与下肺（r = 0.756）以及中肺与下肺区域（r = 0.863）之间的相关性显著（P <.001）。气体陷闭范围从肺上部到下部逐渐增加，区域间存在显著差异（P <.001）。患者与肺区域之间存在显著交互作用（P <.001）。模拟检查方案导致气体陷闭范围存在显著差异（P <.001）。
疑似或确诊细支气管炎患者气体陷闭范围的区域分布存在异质性。由于气体陷闭范围可能取决于检查方案，因此在患者内部和患者之间比较气体陷闭情况时，需要采用相同的方案。
