Department of Radiology, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki City, Kanagawa, Japan.
Jpn J Radiol. 2022 Dec;40(12):1257-1262. doi: 10.1007/s11604-022-01314-w. Epub 2022 Jul 12.
This study aimed to investigate the association between the results of pulmonary function tests (PFTs) in patients with chronic obstructive pulmonary disease (COPD) and the size of their diaphragmatic crus (DC) using inspiratory and expiratory CT.
Thirty-three patients who underwent inspiratory and expiratory CT and PFTs between July and December 2019 were studied retrospectively. The short axis, long axis, and cross-sectional area (CSA) of the bilateral DC were measured, and the percentage change of the DC after expiration (% change of DC) in the size was calculated. The correlation between the results of the PFTs (forced expiratory volume in 1 s [FEV], FEV/forced vital capacity [FVC], and percent predicted FEV [%FEV]) and the size and % change of DC was statistically analyzed.
Significant correlations were observed between the short axis of the right and left DC at expiration and PFTs (FEV, r = -0.35, -0.48, p = 0.04, .007; FEV/FVC, r = -0.52, -0.65, p = 0.002, < .001; %FEV, r = -0.56, -0.60, p < 0.001, < 0.001; respectively), between the CSA of the right DC at expiration and PFTs (FEV/FVC, r = -0.42, p = 0.01; %FEV, r = -0.41, p = 0.017; respectively), and between the % change of the short axis of the left DC and the CSA of the left DC and PFTs (FEV, r = 0.64, 0.56, p < 0.001, .001; %FEV, r = 0.52, 0.51, p = 0.004, 0.004; respectively). The smaller the short axis of the DC and CSA at expiration and the larger the % change in DC of the CSA, the lower the airflow limitation.
There were significant correlations between airflow limitation and the short axis of the bilateral DC at expiration, and the % change in the DC of the CSA. Certain CT measurements of the DC may reflect airflow limitation in patients with COPD.
本研究旨在使用吸气和呼气 CT 探讨慢性阻塞性肺疾病（COPD）患者的肺功能检查（PFT）结果与膈脚（DC）大小之间的关系。
回顾性分析 2019 年 7 月至 12 月间行吸气和呼气 CT 及 PFT 的 33 例患者的资料。测量双侧 DC 的短轴、长轴和横截面积（CSA），并计算呼气后 DC 的大小变化百分比（DC 变化百分比）。对 PFT 结果（用力呼气量 1 秒[FEV]、FEV/用力肺活量[FVC]和预计 FEV%[FEV%]）与 DC 大小和 DC 变化百分比的相关性进行统计学分析。
右、左 DC 短轴在呼气时与 PFT（FEV，r=-0.35、-0.48，p=0.04、0.007；FEV/FVC，r=-0.52、-0.65，p=0.002、<0.001；%FEV，r=-0.56、-0.60，p<0.001、<0.001）之间存在显著相关性，右 DC CSA 在呼气时与 PFT（FEV/FVC，r=-0.42，p=0.01；%FEV，r=-0.41，p=0.017）之间存在显著相关性，左 DC 短轴的 DC 变化百分比与左 DC CSA 和 PFT（FEV，r=0.64、0.56，p<0.001、0.001；%FEV，r=0.52、0.51，p=0.004、0.004）之间存在显著相关性。右、左 DC 短轴和 CSA 呼气时越小，DC CSA 的变化百分比越大，气流受限越低。
气流受限与双侧 DC 呼气时的短轴和 CSA 的 DC 变化百分比之间存在显著相关性。膈脚的某些 CT 测量可能反映 COPD 患者的气流受限。
