Lynch David A, Austin John H M, Hogg James C, Grenier Philippe A, Kauczor Hans-Ulrich, Bankier Alexander A, Barr R Graham, Colby Thomas V, Galvin Jeffrey R, Gevenois Pierre Alain, Coxson Harvey O, Hoffman Eric A, Newell John D, Pistolesi Massimo, Silverman Edwin K, Crapo James D
From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.).
Radiology. 2015 Oct;277(1):192-205. doi: 10.1148/radiol.2015141579. Epub 2015 May 11.
The purpose of this statement is to describe and define the phenotypic abnormalities that can be identified on visual and quantitative evaluation of computed tomographic (CT) images in subjects with chronic obstructive pulmonary disease (COPD), with the goal of contributing to a personalized approach to the treatment of patients with COPD. Quantitative CT is useful for identifying and sequentially evaluating the extent of emphysematous lung destruction, changes in airway walls, and expiratory air trapping. However, visual assessment of CT scans remains important to describe patterns of altered lung structure in COPD. The classification system proposed and illustrated in this article provides a structured approach to visual and quantitative assessment of COPD. Emphysema is classified as centrilobular (subclassified as trace, mild, moderate, confluent, and advanced destructive emphysema), panlobular, and paraseptal (subclassified as mild or substantial). Additional important visual features include airway wall thickening, inflammatory small airways disease, tracheal abnormalities, interstitial lung abnormalities, pulmonary arterial enlargement, and bronchiectasis.
本声明的目的是描述和定义在慢性阻塞性肺疾病(COPD)患者的计算机断层扫描(CT)图像的视觉和定量评估中可以识别的表型异常,目标是为COPD患者的个性化治疗方法做出贡献。定量CT有助于识别和连续评估肺气肿性肺破坏的程度、气道壁的变化以及呼气末气体潴留。然而,CT扫描的视觉评估对于描述COPD中肺结构改变的模式仍然很重要。本文提出并阐述的分类系统为COPD的视觉和定量评估提供了一种结构化方法。肺气肿分为小叶中心型(再细分为微量、轻度、中度、融合型和重度破坏性肺气肿)、全小叶型和间隔旁型(再细分为轻度或重度)。其他重要的视觉特征包括气道壁增厚、炎症性小气道疾病、气管异常、间质性肺异常、肺动脉增粗和支气管扩张。