Vimala Leena Robinson, Gibikote Sridhar, Irodi Aparna, Rajan Manju, Christopher Devasahayam J
Christian Medical College, Vellore, India.
Pol J Radiol. 2019 Oct 3;84:e381-e388. doi: 10.5114/pjr.2019.89306. eCollection 2019.
The aim of the study was to evaluate the role of high-resolution computed tomography (HRCT) in the prediction of presence and severity of chronic obstructive pulmonary disease (COPD), based on the pulmonary function test (PFT), to correlate the various quantitative and qualitative indices of COPD in HRCT with PFT values, and to derive at the threshold values for various quantitative HRCT indices of COPD.
A one-year retrospective and prospective evaluation of the HRCTs of 90 cases and 38 controls was performed. Quantitative and qualitative parameters of COPD were assessed in HRCT and were correlated with PFT.
Among the qualitative parameters, significant correlation with spirometry was found with the qualitative scoring for emphysema and presence and inhomogeneous attenuation. Among the quantitative indices, anterior junction line length, thoracic cage ratio at both aortic arch and inferior pulmonary vein level, thoracic cross-sectional area/[height]² at the aortic arch were found to have good correlation with spirometry. There was significant strong correlation of anterior junction line length and tracheal index with residual volume/total lung capacity (RV/TLC). The threshold values of chest X-ray and HRCT quantitative parameters were calculated and were found to be lower than those of the western population.
HRCT has a definite role in the diagnosis of COPD and can be used to predict the severity of emphysema.
本研究旨在基于肺功能测试(PFT)评估高分辨率计算机断层扫描(HRCT)在预测慢性阻塞性肺疾病(COPD)的存在及严重程度方面的作用,将HRCT中COPD的各种定量和定性指标与PFT值相关联,并得出COPD各种定量HRCT指标的阈值。
对90例病例和38例对照的HRCT进行了为期一年的回顾性和前瞻性评估。在HRCT中评估COPD的定量和定性参数,并将其与PFT相关联。
在定性参数中,发现肺气肿的定性评分、存在情况和不均匀衰减与肺量计有显著相关性。在定量指标中,发现前联合线长度、主动脉弓和肺下静脉水平的胸廓比率、主动脉弓处的胸廓横截面积/[身高]²与肺量计有良好的相关性。前联合线长度和气管指数与残气量/肺总量(RV/TLC)有显著的强相关性。计算了胸部X线和HRCT定量参数的阈值,发现低于西方人群的阈值。
HRCT在COPD的诊断中具有明确作用,可用于预测肺气肿的严重程度。