Bhaskar Ravi, Singh Seema, Singh Pooja
Department of Pulmonary Medicine, Career Institute of Medical Sciences, Lucknow, (UP) India.
Afr Health Sci. 2018 Mar;18(1):90-101. doi: 10.4314/ahs.v18i1.13.
In recent years, there has been increasing interest in diagnosing various components of chronic obstructive pulmonary disease (COPD) using high-resolution computed tomography (HRCT). The present study was undertaken to evaluate HRCT features in patients with COPD.
Fifty patients of COPD (confirmed on Spirometry as per the GOLD guidelines 2014 guidelines) were enrolled, out of which 35 patients got a HRCT done. The Philips computer program for lung densitometry was used with these limits (-800/-1, 024 Hounsfield unit [HU]) to calculate densities, after validating densitometry values with phantoms. We established the area with a free hand drawing of the region of interest, then we established limits (in HUs) and the computer program calculated the attenuation as mean lung density (MLD) of the lower and upper lobes.
There was a significant correlation between smoking index and anteroposterior tracheal diameter (P = 0.036). Tracheal index was found to be decreasing with increasing disease severity which was statistically significant (P = 0.037). A mild linear correlation of pre-forced expiratory volume in the first second (FEV1) was observed with lower lobe and total average MLD while a mild linear correlation of post-FEV1 was observed with both coronal (P = 0.042) and sagittal (P = 0.001) lower lobes MLD. In addition, there was a linear correlation between both pre (P = 0.050) and post (P = 0.024) FEV1/forced vital capacity with sagittal lower lobe MLD.
HRCT may be an important additional tool in the holistic evaluation of COPD.
近年来,使用高分辨率计算机断层扫描(HRCT)诊断慢性阻塞性肺疾病(COPD)的各个组成部分受到越来越多的关注。本研究旨在评估COPD患者的HRCT特征。
纳入50例COPD患者(根据2014年全球慢性阻塞性肺疾病倡议[GOLD]指南通过肺量计确诊),其中35例患者进行了HRCT检查。在使用体模验证密度测定值后,使用飞利浦肺部密度测定计算机程序(-800/-1,024亨氏单位[HU])计算密度。我们通过徒手绘制感兴趣区域来确定区域,然后确定限值(以HU为单位),计算机程序计算下叶和上叶的平均肺密度(MLD)作为衰减值。
吸烟指数与气管前后径之间存在显著相关性(P = 0.036)。发现气管指数随着疾病严重程度的增加而降低,具有统计学意义(P = 0.037)。观察到第一秒用力呼气容积(FEV1)与下叶和总平均MLD之间存在轻度线性相关性,而观察到FEV1后与冠状面(P = 0.042)和矢状面(P = 0.001)下叶MLD之间存在轻度线性相关性。此外,FEV1/用力肺活量前后(P = 0.050)与矢状面下叶MLD之间均存在线性相关性。
HRCT可能是COPD整体评估中的一项重要辅助工具。