Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
J Thorac Imaging. 2011 Nov;26(4):290-300. doi: 10.1097/RTI.0b013e3182277113.
Computed tomography (CT) is the modality of choice for imaging the airways. Volumetric data sets with isotropic spatial resolution based on multidetector thin-section CT with overlapping reconstruction should be used. Chronic obstructive pulmonary disease and asthma are the 2 most common disease entities that are defined by airflow obstruction. The morphologic correlates of airway changes are dilation of the lumen, thickening of the wall, visibility of small airways due to mucus or edema, air trapping, hypoxic vasoconstriction, and collapsibility. To assess air trapping, additional expiratory low-dose scans are recommended. In clinical routine, these findings are visually assessed and should be routinely reported. However, the interobserver variability is high, and there is a clear need for objective software-based measurements. The development of such tools is challenging, and they are just becoming available on a broader scale. Novel techniques based on dual-energy CT aim to measure iodine distribution maps to assess pulmonary perfusion as well as the distribution of inhaled xenon gas to assess the distribution and time course of pulmonary ventilation. However, these techniques are still being investigated in clinical studies. This review will provide an overview of CT for the diagnosis of chronic obstructive pulmonary disease and asthma, its role in phenotyping these diseases, and the measurement of disease severity and functional compromise.
计算机断层扫描（CT）是气道成像的首选方式。应使用基于多层薄层 CT 重叠重建的各向同性空间分辨率的容积数据集。慢性阻塞性肺疾病和哮喘是 2 种最常见的疾病实体，其特征是气流阻塞。气道变化的形态学相关性是管腔扩张、壁增厚、由于黏液或水肿而使小气道可见、空气滞留、缺氧性血管收缩和塌陷。为了评估空气滞留，建议进行额外的呼气低剂量扫描。在临床常规中，这些发现是通过视觉评估的，应该常规报告。然而，观察者间的变异性很高，因此需要客观的基于软件的测量方法。这些工具的开发具有挑战性，并且仅在更广泛的范围内才可用。基于双能 CT 的新技术旨在测量碘分布图，以评估肺灌注以及吸入氙气的分布，以评估肺通气的分布和时间过程。然而，这些技术仍在临床研究中进行研究。这篇综述将介绍 CT 在慢性阻塞性肺疾病和哮喘诊断中的作用、其在这些疾病表型中的作用，以及疾病严重程度和功能损害的测量。
