Department of Big Data Medical Convergence, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea.
Department of Biomedical Research Institute, Kangwon National University Hospital, Chuncheon, Republic of Korea.
Respir Res. 2022 Feb 14;23(1):29. doi: 10.1186/s12931-022-01953-7.
Chest computed tomography (CT) is a widely used method to assess morphological and dynamic abnormalities in chronic obstructive pulmonary disease (COPD). The small pulmonary vascular cross-section (CSA), quantitatively extracted from volumetric CT, is a reliable indicator for predicting pulmonary vascular changes. CSA is associated with the severity of symptoms, pulmonary function tests (PFT) and emphysema and in COPD patients the severity increases over time. We analyzed the correlation longitudinal changes in pulmonary vascular parameters with clinical parameters in COPD patients.
A total of 288 subjects with COPD were investigated during follow up period up to 6 years. CT images were classified into five subtypes from normal to severe emphysema according to percentage of low-attenuation areas less than -950 and -856 Hounsfield units (HU) on inspiratory and expiratory CT (LAA-950, LAA-856). Total number of vessels (N) and total number of vessels with area less than 5 mm (N) per 1 cm of lung surface area (LSA) were measured at 6 mm from the pleural surface.
N/LSA and N/LSA changed from 1.16 ± 0.27 to 0.87 ± 0.2 and from 1.02 ± 0.22 to 0.78 ± 0.22, respectively, during Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage progression. Both parameters changed from normal to severe emphysema according to CT subtype from 1.39 ± 0.21 to 0.74 ± 0.17 and from 1.18 ± 0.19 to 0.67 ± 0.15, respectively. LAA-950 and LAA-856exp were negatively correlated with N/LSA (r = - 0.738, - 0.529) and N /LSA (r = - 0.729, -- .497). On the other hand, pulmonary function test (PFT) results showed a weak correlation with N/LSA and N/LSA (r = 0.205, 0.210). The depth in CT subtypes for longitudinal change both N/LSA and N/LSA was (- 0.032, - 0.023) and (- 0.027) in normal and SAD, respectively.
Quantitative computed tomography features faithfully reflected pulmonary vessel alterations, showing in particular that pulmonary vascular alteration started.
胸部计算机断层扫描（CT）是一种广泛用于评估慢性阻塞性肺疾病（COPD）形态和动态异常的方法。从容积 CT 中定量提取的小肺血管横截面积（CSA）是预测肺血管变化的可靠指标。CSA与症状严重程度、肺功能检查（PFT）和肺气肿有关，在 COPD 患者中，随着时间的推移，严重程度会增加。我们分析了 COPD 患者肺血管参数的纵向变化与临床参数之间的相关性。
共对 288 例 COPD 患者进行了为期 6 年的随访研究。根据吸气和呼气 CT 上低于-950 和-856 豪斯菲尔德单位（HU）的低衰减区百分比，将 CT 图像分为从正常到严重肺气肿的五个亚型（LAA-950、LAA-856）。在胸膜表面 6 毫米处测量每 1 平方厘米肺表面积（LSA）的血管总数（N）和面积小于 5 毫米的血管总数（N）。
GOLD 分期进展过程中，N/LSA 和 N/LSA 分别从 1.16±0.27 降至 0.87±0.2 和 1.02±0.22 降至 0.78±0.22。根据 CT 亚型，从正常到严重肺气肿，N/LSA 和 N/LSA 分别从 1.39±0.21 降至 0.74±0.17 和 1.18±0.19 降至 0.67±0.15。LAA-950 和 LAA-856exp 与 N/LSA（r=-0.738，-0.529）和 N/LSA（r=-0.729，--0.497）呈负相关。另一方面，肺功能检查（PFT）结果与 N/LSA 和 N/LSA 呈弱相关（r=0.205，0.210）。在 CT 亚型中，N/LSA 和 N/LSA 的纵向变化深度分别为（-0.032，-0.023）和（-0.027）在正常和 SAD 中。
定量 CT 特征忠实地反映了肺血管的改变，特别是表明肺血管的改变已经开始。
