Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan,
Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan.
Respiration. 2020;99(5):382-388. doi: 10.1159/000506881. Epub 2020 Apr 29.
The aim of this study was to determine the utility of dynamic-ventilatory digital radiography (DR) for pulmonary function assessment in patients with airflow limitation.
One hundred and eighteen patients with airflow limitation (72 patients with lung cancer before surgery, 35 patients with chronic obstructive pulmonary disease [COPD], 6 patients with asthma, and 5 patients with asthma-COPD overlap syndrome) were assessed with dynamic-ventilatory DR. The patients were instructed to inhale and exhale slowly and maximally. Sequential chest X-ray images were captured in 15 frames per second using a dynamic flat-panel imaging system. The relationship between the lung area and the rate of change in the lung area due to respiratory motion with respect to pulmonary function was analyzed.
The rate of change in the lung area from maximum inspiration to maximum expiration (Rs ratio) was associated with the RV/TLC ratio (r = 0.48, p < 0.01) and the percentage of the predicted FEV1 (r = -0.33, p < 0.01) in patients with airflow limitations. The Rs ratio also decreased in an FEV1-dependent manner.
The rate of change in the lung area due to respiratory motion evaluated with dynamic DR reflects air trapping. Dynamic DR is a potential tool for the comprehensive assessment of pulmonary function in patients with COPD.
本研究旨在确定动态通气数字 X 线摄影（DR）在气流受限患者肺功能评估中的应用价值。
对 118 例气流受限患者（72 例肺癌术前患者、35 例慢性阻塞性肺疾病[COPD]患者、6 例哮喘患者和 5 例哮喘-COPD 重叠综合征患者）进行了动态通气 DR 评估。患者被要求缓慢而最大程度地吸气和呼气。使用动态平板成像系统以每秒 15 帧的速度连续拍摄胸部 X 射线图像。分析了呼吸运动引起的肺面积与肺功能之间的肺面积变化率之间的关系。
从最大吸气到最大呼气时肺面积的变化率（Rs 比值）与 RV/TLC 比值（r = 0.48，p < 0.01）和预计 FEV1 的百分比（r = -0.33，p < 0.01）相关在气流受限患者中。Rs 比值也以依赖于 FEV1 的方式降低。
用动态 DR 评估的呼吸运动引起的肺面积变化率反映了空气滞留。动态 DR 是 COPD 患者全面评估肺功能的潜在工具。
