Lopes A J, Mogami R, Camilo G B, Machado D C, Melo P L, Carvalho A R S
1 Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Br J Radiol. 2015 May;88(1049):20150028. doi: 10.1259/bjr.20150028. Epub 2015 Mar 6.
To evaluate the correlations between pulmonary densitometry values and forced oscillation technique (FOT) parameters in patients with silicosis.
This cross-sectional study comprised 36 non-smoker patients with silicosis and 20 matched control subjects who were submitted to FOT and multidetector CT (MDCT).
Compared with the control subjects, the MDCT evaluation demonstrated that patients with silicosis exhibited greater total lung mass. These patients also had larger non-aerated and poorly aerated compartments, which included nodules and scarring. Compared with the control subjects, FOT evaluation demonstrated that patients with silicosis exhibited changes in both reactive and resistive properties of the respiratory system. In these patients, there was a greater heterogeneity of the respiratory system and increased work of breathing. Significant correlations between non-aerated compartment size and FOT parameters that reflect the non-homogeneity of the respiratory system were observed. The dynamic compliance of the respiratory system was negatively correlated with non-aerated compartment size, while the impedance at 4 Hz was positively correlated with non-aerated compartment size.
Patients with silicosis have heavier lungs. In these patients, a larger non-aerated compartment is associated with a worsening of lung function. A more significant pulmonary involvement is associated with a loss of homogeneity and increased mechanical load of the respiratory system. Advances in knowledge The findings provided by both pulmonary densitometry and FOT may add valuable information to the subjective analysis of silicosis; however, more studies are necessary to evaluate the potential use of these methods for assessing disease progression.
评估矽肺患者肺密度测定值与强迫振荡技术(FOT)参数之间的相关性。
这项横断面研究纳入了36名不吸烟的矽肺患者和20名匹配的对照受试者,他们均接受了FOT和多排螺旋CT(MDCT)检查。
与对照受试者相比,MDCT评估显示矽肺患者的全肺质量更大。这些患者还存在更大的无气和通气不良区域,包括结节和瘢痕。与对照受试者相比,FOT评估显示矽肺患者的呼吸系统反应性和阻力特性均发生了变化。在这些患者中,呼吸系统的异质性更大,呼吸功增加。观察到无气区域大小与反映呼吸系统非均质性的FOT参数之间存在显著相关性。呼吸系统的动态顺应性与无气区域大小呈负相关,而4Hz时的阻抗与无气区域大小呈正相关。
矽肺患者的肺部更重。在这些患者中,更大的无气区域与肺功能恶化相关。更严重的肺部受累与呼吸系统均质性丧失和机械负荷增加有关。知识进展 肺密度测定和FOT提供的结果可能会为矽肺的主观分析增添有价值的信息;然而,需要更多研究来评估这些方法在评估疾病进展方面的潜在用途。