在潮气呼吸期间,使用4D-CT成像对健康人肺部进行区域通气和变形评估。

Assessment of regional ventilation and deformation using 4D-CT imaging for healthy human lungs during tidal breathing.

作者信息

Jahani Nariman, Choi Sanghun, Choi Jiwoong, Iyer Krishna, Hoffman Eric A, Lin Ching-Long

机构信息

Department of Mechanical and Industrial Engineering, The University of Iowa, Iowa City, Iowa; IIHR-Hydroscience and Engineering, The University of Iowa, Iowa City, Iowa;

Department of Biomedical Engineering, The University of Iowa, Iowa City, Iowa;

出版信息

J Appl Physiol (1985). 2015 Nov 15;119(10):1064-74. doi: 10.1152/japplphysiol.00339.2015. Epub 2015 Aug 27.

Abstract

This study aims to assess regional ventilation, nonlinearity, and hysteresis of human lungs during dynamic breathing via image registration of four-dimensional computed tomography (4D-CT) scans. Six healthy adult humans were studied by spiral multidetector-row CT during controlled tidal breathing as well as during total lung capacity and functional residual capacity breath holds. Static images were utilized to contrast static vs. dynamic (deep vs. tidal) breathing. A rolling-seal piston system was employed to maintain consistent tidal breathing during 4D-CT spiral image acquisition, providing required between-breath consistency for physiologically meaningful reconstructed respiratory motion. Registration-derived variables including local air volume and anisotropic deformation index (ADI, an indicator of preferential deformation in response to local force) were employed to assess regional ventilation and lung deformation. Lobar distributions of air volume change during tidal breathing were correlated with those of deep breathing (R(2) ≈ 0.84). Small discrepancies between tidal and deep breathing were shown to be likely due to different distributions of air volume change in the left and the right lungs. We also demonstrated an asymmetric characteristic of flow rate between inhalation and exhalation. With ADI, we were able to quantify nonlinearity and hysteresis of lung deformation that can only be captured in dynamic images. Nonlinearity quantified by ADI is greater during inhalation, and it is stronger in the lower lobes (P < 0.05). Lung hysteresis estimated by the difference of ADI between inhalation and exhalation is more significant in the right lungs than that in the left lungs.

摘要

本研究旨在通过四维计算机断层扫描(4D-CT)扫描的图像配准,评估动态呼吸过程中人类肺部的区域通气、非线性和滞后现象。对6名健康成年人在控制潮气量呼吸以及肺总量和功能残气量屏气期间进行螺旋多排探测器CT研究。利用静态图像对比静态呼吸与动态(深呼吸与潮气量呼吸)呼吸。在4D-CT螺旋图像采集过程中,采用滚动密封活塞系统维持一致的潮气量呼吸,为具有生理意义的重建呼吸运动提供呼吸间所需的一致性。利用配准得出的变量,包括局部空气体积和各向异性变形指数(ADI,响应局部力的优先变形指标)来评估区域通气和肺部变形。潮气量呼吸期间肺叶空气体积变化的分布与深呼吸期间的分布相关(R(2)≈0.84)。潮气量呼吸和深呼吸之间的微小差异可能是由于左右肺空气体积变化的不同分布所致。我们还证明了吸气和呼气之间流速的不对称特征。通过ADI,我们能够量化只能在动态图像中捕捉到的肺部变形的非线性和滞后现象。由ADI量化的非线性在吸气期间更大,在下叶更强(P<0.05)。通过吸气和呼气之间ADI的差异估计的肺滞后现象在右肺比左肺更显著。

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