Manners David, Wong Patrick, Murray Conor, Teh Joelin, Kwok Yi Jin, de Klerk Nick, Alfonso Helman, Franklin Peter, Reid Alison, Musk A W Bill, Brims Fraser J H
Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Ground Floor B-block, Hospital Avenue, Nedlands, WA, Australia.
Department of Diagnostic Imaging, Royal Perth Hospital, Perth, Australia.
Eur Radiol. 2017 Aug;27(8):3485-3490. doi: 10.1007/s00330-016-4722-7. Epub 2017 Jan 12.
The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population.
Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO).
Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001).
Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis.
• Interobserver agreement for the ILD score using prone ULDCT is good. • Prone ULDCT appearances of ILD correlate with changes in spirometric observations. • Prone ULDCT appearances of ILD correlate strongly with changes in gas transfer. • Prone ULDCT may provide sufficient radiological evidence to inform the diagnosis of asbestosis.
超低剂量计算机断层扫描(ULDCT)检测到的肺实质变化与肺功能异常之间的相关性尚无充分描述。本研究旨在确定在石棉暴露人群中,ULDCT检测到的间质性肺疾病(ILD)与肺功能指标之间的关系。
两名胸部放射科医生在不了解石棉暴露情况或肺功能的前提下,对143名参与者的俯卧位ULDCT扫描结果进行独立分类,将ILD表现分为无(评分为0)、可能(1)或确定(2)。肺功能指标包括肺活量测定和一氧化碳弥散量(DLCO)。
参与者中92%为男性,中位年龄为73.0岁。CT剂量指数体积在0.6至1.8毫西弗之间。63名(44.1%)参与者报告有可能或确定的ILD。观察者间一致性良好(k = 0.613,p < 0.001)。ILD评分与第1秒用力呼气量(FEV)和用力肺活量(FVC)均存在统计学显著相关性(r = -0.17,p = 0.04;r = -0.20,p = 0.02)。ILD评分与DLCO之间存在强相关性(r = -0.34,p < 0.0001)。
ULDCT上与ILD一致的变化与气体交换相应减少密切相关,与标准CT相似。在石棉暴露人群中,ULDCT可能足以检测到与石棉肺一致的放射学变化。
• 使用俯卧位ULDCT对ILD评分的观察者间一致性良好。• ILD的俯卧位ULDCT表现与肺活量测定观察结果的变化相关。• ILD的俯卧位ULDCT表现与气体交换变化密切相关。• 俯卧位ULDCT可能提供足够的放射学证据以辅助石棉肺的诊断。