Kloth C, Thaiss W M, Hetzel J, Ditt H, Grosse U, Nikolaou K, Horger M
Department of Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.
Department of Internal Medicine II, Eberhard Karls University, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.
Eur Radiol. 2016 Jul;26(7):2176-83. doi: 10.1007/s00330-015-4033-4. Epub 2015 Oct 5.
To assess the impact of endobronchial coiling on the segment bronchus cross-sectional area and volumes in patients with lung emphysema using quantitative chest-CT measurements.
Thirty patients (female = 15; median age = 65.36 years) received chest-CT before and after endobronchial coiling for lung volume reduction (LVR) between January 2010 and December 2014. Thin-slice (0.6 mm) non-enhanced image data sets were acquired both at end-inspiration and end-expiration using helical technique and 120 kV/100-150 mAs. Clinical response was defined as an increase in the walking distance (Six-minute walk test; 6MWT) after LVR-therapy. Additionally, pulmonary function test (PFT) measurements were used for clinical correlation.
In the treated segmental bronchia, the cross-sectional lumen area showed significant reduction (p < 0.05) in inspiration and tendency towards enlargement in expiration (p > 0.05). In the ipsilateral lobes, the lumina showed no significant changes. In the contralateral lung, we found tendency towards increased cross-sectional area in inspiration (p = 0.06). Volumes of the treated segments correlated with the treated segmental bronchial lumina in expiration (r = 0.80, p < 0.001). Clinical correlation with changes in 6MWT/PFT showed a significant decrease of the inspiratory volume of the treated lobe in responders only.
Endobronchial coiling causes significant decrease in the cross-sectional area of treated segment bronchi in inspiration and a slight increase in expiration accompanied by a volume reduction.
• Endobronchial coiling has indirect impact on cross-sectional area of treated segment bronchi • Volume changes of treated lobes correlate with changes in bronchial cross-sectional area • Coil-induced effects reflect their stabilizing and stiffening impact on lung parenchyma • Endobronchial coiling reduces bronchial collapsing compensating the loss of elasticity.
采用定量胸部CT测量评估支气管内圈套术对肺气肿患者节段支气管横截面积和容积的影响。
2010年1月至2014年12月期间，30例患者（女性15例；中位年龄65.36岁）在接受支气管内圈套术以减少肺容积（LVR）前后接受了胸部CT检查。使用螺旋技术和120 kV/100 - 150 mAs在吸气末和呼气末采集薄层（0.6 mm）非增强图像数据集。临床反应定义为LVR治疗后步行距离增加（六分钟步行试验；6MWT）。此外，肺功能测试（PFT）测量用于临床相关性分析。
在治疗的节段支气管中，吸气时横截面积显著减小（p < 0.05），呼气时有增大趋势（p > 0.05）。同侧肺叶的管腔无显著变化。在对侧肺中，吸气时横截面积有增大趋势（p = 0.06）。治疗节段的容积与呼气时治疗的节段支气管管腔相关（r = 0.80，p < 0.001）。6MWT/PFT变化的临床相关性仅在反应者中显示治疗肺叶吸气容积显著降低。
支气管内圈套术导致治疗节段支气管吸气时横截面积显著减小，呼气时略有增加并伴有容积减小。
• 支气管内圈套术对治疗节段支气管的横截面积有间接影响 • 治疗肺叶的容积变化与支气管横截面积变化相关 • 圈套术引起的效应反映了它们对肺实质的稳定和硬化作用 • 支气管内圈套术减少支气管塌陷，补偿弹性丧失。
