肺叶 collapsibility 指数分析评估 COPD 患者的功能肺容量。
Lobar analysis of collapsibility indices to assess functional lung volumes in COPD patients.
机构信息
Department of Radiology, Nagoya University, Nagoya, Aichi, Japan.
Department of Respiratory Medicine, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.
出版信息
Int J Chron Obstruct Pulmon Dis. 2014 Dec 9;9:1347-56. doi: 10.2147/COPD.S72616. eCollection 2014.
BACKGROUND
We investigated correlations between lung volume collapsibility indices and pulmonary function test (PFT) results and assessed lobar differences in chronic obstructive pulmonary disease (COPD) patients, using paired inspiratory and expiratory three dimensional (3D) computed tomography (CT) images.
METHODS
We retrospectively assessed 28 COPD patients who underwent paired inspiratory and expiratory CT and PFT exams on the same day. A computer-aided diagnostic system calculated total lobar volume and emphysematous lobar volume (ELV). Normal lobar volume (NLV) was determined by subtracting ELV from total lobar volume, both for inspiratory phase (NLVI) and for expiratory phase (NLVE). We also determined lobar collapsibility indices: NLV collapsibility ratio (NLVCR) (%)=(1-NLVE/NLVI)×100%. Associations between lobar volumes and PFT results, and collapsibility indices and PFT results were determined by Pearson correlation analysis.
RESULTS
NLVCR values were significantly correlated with PFT results. Forced expiratory volume in 1 second, measured as percent of predicted results (FEV1%P) was significantly correlated with NLVCR values for the lower lobes (P<0.01), whereas this correlation was not significant for the upper lobes (P=0.05). FEV1%P results were also moderately correlated with inspiratory, expiratory ELV (ELVI,E) for the lower lobes (P<0.05). In contrast, the ratio of the diffusion capacity for carbon monoxide to alveolar gas volume, measured as percent of predicted (DLCO/VA%P) results were strongly correlated with ELVI for the upper lobes (P<0.001), whereas this correlation with NLVCR values was weaker for upper lobes (P<0.01) and was not significant for the lower lobes (P=0.26).
CONCLUSION
FEV1%P results were correlated with NLV collapsibility indices for lower lobes, whereas DLCO/VA%P results were correlated with NLV collapsibility indices and ELV for upper lobes. Thus, evaluating lobar NLV collapsibility might be useful for estimating pulmonary function in COPD patients.
背景
我们通过使用配对吸气和呼气三维（3D）计算机断层扫描（CT）图像，研究了肺容积塌陷指数与肺功能测试（PFT）结果之间的相关性，并评估了慢性阻塞性肺疾病（COPD）患者的肺叶差异。
方法
我们回顾性评估了 28 例同一天接受配对吸气和呼气 CT 和 PFT 检查的 COPD 患者。计算机辅助诊断系统计算总肺叶体积和肺气肿肺叶体积（ELV）。通过从总肺叶体积中减去 ELV 来确定正常肺叶体积（NLV），分别为吸气相（NLVI）和呼气相（NLVE）。我们还确定了肺叶塌陷指数：NLV 塌陷比（NLVCR）（%）=（1-NLVE/NLVI）×100%。通过 Pearson 相关分析确定肺叶体积与 PFT 结果、塌陷指数与 PFT 结果之间的相关性。
结果
NLVCR 值与 PFT 结果显著相关。1 秒用力呼气量，以预计值的百分比表示（FEV1%P）与下叶的 NLVCR 值显著相关（P<0.01），而上叶则不显著（P=0.05）。FEV1%P 结果也与下叶的吸气、呼气 ELV（ELVI，E）中度相关（P<0.05）。相比之下，一氧化碳弥散量与肺泡气容积的比值，以预计值的百分比表示（DLCO/VA%P）结果与上叶的 ELVI 呈强相关（P<0.001），而上叶的 NLVCR 值与上叶的相关性较弱（P<0.01），而下叶的相关性不显著（P=0.26）。
结论
FEV1%P 结果与下叶的 NLV 塌陷指数相关，而 DLCO/VA%P 结果与上叶的 NLV 塌陷指数和 ELV 相关。因此，评估肺叶 NLV 塌陷性可能有助于估计 COPD 患者的肺功能。
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