Department of Radiology, EB49, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700RB, Groningen, The Netherlands.
Department of Pulmonology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Eur Radiol. 2022 Aug;32(8):5308-5318. doi: 10.1007/s00330-022-08600-1. Epub 2022 Feb 22.
Research on computed tomography (CT) bronchial parameter measurements shows that there are conflicting results on the values for bronchial parameters in the never-smoking, smoking, asthma, and chronic obstructive pulmonary disease (COPD) populations. This review assesses the current CT methods for obtaining bronchial wall parameters and their comparison between populations.
A systematic review of MEDLINE and Embase was conducted following PRISMA guidelines (last search date 25th October 2021). Methodology data was collected and summarised. Values of percentage wall area (WA%), wall thickness (WT), summary airway measure (Pi10), and luminal area (Ai) were pooled and compared between populations.
A total of 169 articles were included for methodologic review; 66 of these were included for meta-analysis. Most measurements were obtained from multiplanar reconstructions of segmented airways (93 of 169 articles), using various tools and algorithms; third generation airways in the upper and lower lobes were most frequently studied. COPD (12,746) and smoking (15,092) populations were largest across studies and mostly consisted of men (median 64.4%, IQR 61.5 - 66.1%). There were significant differences between populations; the largest WA% was found in COPD (mean SD 62.93 ± 7.41%, n = 6,045), and the asthma population had the largest Pi10 (4.03 ± 0.27 mm, n = 442). Ai normalised to body surface area (Ai/BSA) (12.46 ± 4 mm, n = 134) was largest in the never-smoking population.
Studies on CT-derived bronchial parameter measurements are heterogenous in methodology and population, resulting in challenges to compare outcomes between studies. Significant differences between populations exist for several parameters, most notably in the wall area percentage; however, there is a large overlap in their ranges.
• Diverse methodology in measuring airways contributes to overlap in ranges of bronchial parameters among the never-smoking, smoking, COPD, and asthma populations. • The combined number of never-smoking participants in studies is low, limiting insight into this population and the impact of participant characteristics on bronchial parameters. • Wall area percent of the right upper lobe apical segment is the most studied (87 articles) and differentiates all except smoking vs asthma populations.
对计算机断层扫描（CT）支气管参数测量的研究表明，在不吸烟、吸烟、哮喘和慢性阻塞性肺疾病（COPD）人群中，支气管参数值存在相互矛盾的结果。本综述评估了目前用于获取支气管壁参数的 CT 方法及其在人群中的比较。
按照 PRISMA 指南（最后检索日期为 2021 年 10 月 25 日）对 MEDLINE 和 Embase 进行系统综述。收集并总结了方法学数据。汇总并比较了不同人群的百分比壁面积（WA%）、壁厚度（WT）、总气道测量值（Pi10）和腔面积（Ai）。
共纳入 169 篇文章进行方法学评价；其中 66 篇文章进行了荟萃分析。大多数测量值是从分段气道的多平面重建中获得的（169 篇文章中有 93 篇），使用了各种工具和算法；上、下叶的第三代气道是最常研究的。COPD（12746 人）和吸烟（15092 人）人群在所有研究中最大，主要由男性组成（中位数 64.4%，IQR 61.5-66.1%）。不同人群之间存在显著差异；COPD 患者的 WA%最大（平均值标准差 62.93±7.41%，n=6045），哮喘患者的 Pi10 最大（4.03±0.27mm，n=442）。与体表面积（Ai/BSA）归一化的 Ai（12.46±4mm，n=134）在不吸烟人群中最大。
CT 衍生的支气管参数测量研究在方法学和人群方面存在异质性，导致研究之间的结果难以比较。几个参数在不同人群之间存在显著差异，最显著的是壁面积百分比；然而，它们的范围有很大的重叠。
气道测量方法的多样性导致不吸烟、吸烟、COPD 和哮喘人群的支气管参数范围重叠。
研究中不吸烟参与者的总数较低，限制了对该人群的了解以及参与者特征对支气管参数的影响。
右肺上叶尖段的壁面积百分比研究最多（87 篇文章），可区分除吸烟与哮喘人群之外的所有人群。
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