Department of Mathematics & Statistics, Villanova University, PA, United States of America. was at Department of Mathematics, Colorado State University, CO, United States of America.
Physiol Meas. 2018 Apr 26;39(4):045008. doi: 10.1088/1361-6579/aab8c4.
Lung function monitoring by spirometry plays a critical role in the clinical care of pediatric cystic fibrosis (CF) patients, but many young children are unable to perform spirometry, and the outputs are often normal even in the presence of lung disease. Measures derived from electrical impedance tomography (EIT) images were studied for their utility as potential surrogates for spirometry in CF patients and to assess response to intravenous antibiotic treatment for acute pulmonary exacerbations (PEx) in a subset of patients.
EIT data were collected on 35 subjects (21 with CF, 14 healthy controls, 8 CF patients pre- and post-treatment for an acute PEx) ages 2 to 20 years during tidal breathing and also concurrently with spirometry on subjects over age 8. EIT-derived measures of FEV1, FVC, and FEV1/FVC were computed globally and regionally from dynamic EIT images.
Global EIT-derived FEV1/FVC showed good correlation with spirometry FEV1/FVC values (r = 0.54, p = 0.01), and were able to distinguish between the groups (p = 0.01). Lung heterogeneity was assessed through the spatial coefficient of variation (CV) of EIT difference images between key time points, and the CVs for EIT-derived FEV1 and FVC showed significant correlation with the CV for tidal breathing (r = 0.47, p = 0.01 and r = 0.50, p = 0.01, respectively). Global EIT-derived FEV1/FVC was better able to distinguish between groups than spirometry FEV1 (F-values 776.5 and 146.3, respectively, p < 0.01.) The same held true for the CVs for EIT-derived FEV1, FVC, and tidal breathing (F-values 215.93, 193.89, 204.57, respectively, p < 0.01).
The strong correlation between the CVs for tidal breathing, FEV1, and FVC, and the statistically significant ability of CV for tidal breathing to distinguish between healthy subjects and CF patients, and between the studied CF disease states suggests that the CV may be useful for measuring the extent and severity of structural lung disease.
通过肺活量测定法监测肺功能在小儿囊性纤维化 (CF) 患者的临床护理中起着至关重要的作用，但许多幼儿无法进行肺活量测定法，并且即使存在肺部疾病，其结果也常常正常。本研究研究了从电阻抗断层成像 (EIT) 图像得出的测量值是否可作为 CF 患者肺活量测定法的潜在替代指标，并评估了该测量值在一部分患者中对静脉内抗生素治疗急性肺部加重 (PEx) 的反应。
在静息呼吸时，对 35 名年龄在 2 至 20 岁的受试者（21 名 CF 患者、14 名健康对照者、8 名 CF 患者在急性 PEx 治疗前后）收集 EIT 数据，并且在年龄大于 8 岁的受试者中同时与肺活量测定法同步进行。从动态 EIT 图像计算整体和区域的 EIT 衍生的 FEV1、FVC 和 FEV1/FVC。
全球 EIT 衍生的 FEV1/FVC 与肺活量测定法 FEV1/FVC 值具有良好的相关性（r = 0.54，p = 0.01），并且能够区分组间差异（p = 0.01）。通过关键时间点之间的 EIT 差值图像的空间变异系数 (CV) 评估肺异质性，EIT 衍生的 FEV1 和 FVC 的 CV 与潮气呼吸的 CV 呈显著相关性（r = 0.47，p = 0.01 和 r = 0.50，p = 0.01，分别）。与肺活量测定法 FEV1 相比，全球 EIT 衍生的 FEV1/FVC 能够更好地区分组间差异（F 值分别为 776.5 和 146.3，p < 0.01）。EIT 衍生的 FEV1、FVC 和潮气呼吸的 CV 也是如此（F 值分别为 215.93、193.89 和 204.57，p < 0.01）。
潮气呼吸、FEV1 和 FVC 的 CV 之间具有很强的相关性，并且 CV 能够区分健康受试者和 CF 患者，以及所研究的 CF 疾病状态之间的差异具有统计学意义，这表明 CV 可能有助于测量结构性肺病的程度和严重程度。
