Nishimura Masaharu
First Department of Medicine, Hokkaido University School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.
Proc Am Thorac Soc. 2008 Dec 15;5(9):910-4. doi: 10.1513/pats.200809-109QC.
Three-dimensional airway analysis, using high-resolution computed tomography (CT), has only recently become a reality for studying airway dimensions and remodeling in chronic obstructive pulmonary disease (COPD). Herein, we show how we validated our new software using phantoms, and how we applied this software to a clinical study. Using this software, we have demonstrated that the percentage of predicted forced expiratory volume in 1 second in patients with COPD correlated highly with airway luminal area and, to a lesser extent, with percentage wall thickening (WA%) from the 3rd to the 6th generation of both the apical upper bronchus (B1) and the anterior lower bronchus (B8). More importantly, we also showed that correlation coefficients improved with decreasing airway size in both airways. In the near future, with further advances in both software and CT technology, this kind of approach will become even more attractive. Using this readily accessible and relatively noninvasive technique, we are conducting a longitudinal study of subjects recruited for the Hokkaido COPD cohort study. Potential problems in the application of three-dimensional airway analysis to such longitudinal follow-up studies and/or large-scale multicenter studies are also discussed.
使用高分辨率计算机断层扫描（CT）进行的三维气道分析，直到最近才成为研究慢性阻塞性肺疾病（COPD）气道尺寸和重塑的现实手段。在此，我们展示了我们如何使用模型验证我们的新软件，以及我们如何将该软件应用于一项临床研究。使用该软件，我们已经证明，COPD患者一秒用力呼气量预测值的百分比与气道管腔面积高度相关，并且在较小程度上与尖段上叶支气管（B1）和前基底段下叶支气管（B8）第3至第6代的壁增厚百分比（WA%）相关。更重要的是，我们还表明，在两个气道中，随着气道尺寸减小，相关系数会提高。在不久的将来，随着软件和CT技术的进一步发展，这种方法将变得更具吸引力。利用这种易于获取且相对无创的技术，我们正在对为北海道COPD队列研究招募的受试者进行纵向研究。还讨论了将三维气道分析应用于此类纵向随访研究和/或大规模多中心研究中的潜在问题。
