Fan Li, Xia Yi, Guan Yu, Zhang Tie-feng, Liu Shi-yuan
Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, China.
Clin Respir J. 2014 Jan;8(1):45-54. doi: 10.1111/crj.12033. Epub 2013 Jul 31.
Computed tomography (CT) and magnetic resonance imaging (MRI) can provide detailed anatomic structures and quantitative function information for chronic obstructive pulmonary disease (COPD).
To prospectively clarify characteristics of pulmonary function test (PFT), CT volume parameters and magnetic resonance (MR) perfusion imaging in COPD patients with different high-resolution computed tomography (HRCT) phenotypes.
Sixty-two patients performed PFT, CT and MR perfusion imaging. COPD was classified into three phenotypes according to HRCT quantitative findings: A, E and M phenotype. Total lung volume (TLV), total emphysema volume (TEV) and emphysema index (EI) were quantitated by HRCT. In cases of perfusion defects (PDs), the shape and size were evaluated. The contrast between the normal lung and PDs was quantified by calculating their signal intensity ratio (RSI = SIPD /SInormal ). The correlation was performed between PFT, CT and MR perfusion.
There were 42 A phenotype, 9 E phenotype and 11 M phenotype. There was significant difference in forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) between A and M phenotype (P < 0.05). TEV and EI of A phenotype (0.4 ± 0.4 L and 8.0% ± 4.3%) were lower than those of E (1.0 ± 0.3 L and 18.6% ± 3.2%) or M phenotype (0.9 ± 0.2 L and 17.5% ± 1.7%). MR perfusion images showed circumscribed or diffuse patchy PDs. RSI of A phenotype was higher than that of E phenotype (20.3% ± 8.5% vs 11.8% ± 5.4%; P = 0.006). TEV and EI were moderate negatively correlated with diffusion function parameters. RSI was strongly correlated with FEV1% (A) and FEV1/FVC (M). FEV1/FVC was strongly correlated with TEV or EI (E).
There were different features and correlations between PFT, CT volume and MR perfusion in different phenotype, indicating each phenotype may have novel imaging method guiding clinical management.
计算机断层扫描（CT）和磁共振成像（MRI）可为慢性阻塞性肺疾病（COPD）提供详细的解剖结构和定量功能信息。
前瞻性地阐明不同高分辨率计算机断层扫描（HRCT）表型的COPD患者的肺功能测试（PFT）、CT容积参数和磁共振（MR）灌注成像的特征。
62例患者进行了PFT、CT和MR灌注成像。根据HRCT定量结果，将COPD分为三种表型：A、E和M表型。通过HRCT定量全肺容积（TLV）、全肺气肿容积（TEV）和肺气肿指数（EI）。对于灌注缺损（PDs），评估其形状和大小。通过计算正常肺与PDs之间的信号强度比（RSI = SIPD / SInormal）来量化两者之间的对比度。对PFT、CT和MR灌注之间进行相关性分析。
有42例A表型、9例E表型和11例M表型。A表型和M表型之间的1秒用力呼气容积（FEV1）/用力肺活量（FVC）有显著差异（P < 0.05）。A表型的TEV和EI（0.4±0.4L和8.0%±4.3%）低于E表型（1.0±0.3L和18.6%±3.2%）或M表型（0.9±0.2L和17.5%±1.7%）。MR灌注图像显示有局限性或弥漫性斑片状PDs。A表型的RSI高于E表型（20.3%±8.5%对11.8%±5.4%；P = 0.006）。TEV和EI与扩散功能参数呈中度负相关。RSI与FEV1%（A）和FEV1/FVC（M）呈强相关。FEV1/FVC与TEV或EI（E）呈强相关。
不同表型的PFT、CT容积和MR灌注之间存在不同的特征和相关性，表明每种表型可能有新的成像方法指导临床管理。
