Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
Respiration. 2022;101(12):1110-1120. doi: 10.1159/000527067. Epub 2022 Nov 9.
Correlations between upright CT and pulmonary function test (PFT) measurements, and differences in lung/lobe/airway volumes between supine and standing positions in patients with chronic obstructive pulmonary disease (COPD) remain unknown.
The study aimed to evaluate correlations between lung/airway volumes on both supine and upright CT and PFT measurements in patients with COPD, and compare CT-based inspiratory/expiratory lung/lobe/airway volumes between the two positions.
Forty-eight patients with COPD underwent both conventional supine and upright CT in a randomized order during inspiration and expiration breath-holds, and PFTs within 2 h. We measured the lung/lobe/airway volumes on both CT.
The correlation coefficients between total lung volumes on inspiratory CT in supine/standing position and PFT total lung capacity and vital capacity were 0.887/0.920 and 0.711/0.781, respectively; between total lung volumes on expiratory CT in supine/standing position and PFT functional residual capacity and residual volume, 0.676/0.744 and 0.713/0.739, respectively; and between airway volume on inspiratory CT in supine/standing position and PFT forced expiratory volume in 1 s, 0.471/0.524, respectively. Inspiratory/expiratory bilateral upper and right lower lobe, bilateral lung, and airway volumes were significantly higher in the standing than supine position (3.6-21.2% increases, all p < 0.05); however, inspiratory/expiratory right middle lobe volumes were significantly lower in the standing position (4.6%/15.9% decreases, respectively, both p < 0.001).
Upright CT-based volumes were more correlated with PFT measurements than supine CT-based volumes in patients with COPD. Unlike other lobes and airway, inspiratory/expiratory right middle lobe volumes were significantly lower in the standing than supine position.
慢性阻塞性肺疾病（COPD）患者直立 CT 与肺功能测试（PFT）测量之间的相关性，以及仰卧位和站立位之间肺/叶/气道体积的差异尚不清楚。
本研究旨在评估 COPD 患者仰卧和直立 CT 上的肺/气道体积与 PFT 测量值之间的相关性，并比较两种体位下基于 CT 的吸气/呼气肺/叶/气道体积。
48 例 COPD 患者在 2 小时内接受了常规仰卧和直立 CT 检查，并在吸气和呼气屏气期间进行了随机排序，同时还进行了 PFT 检查。我们测量了仰卧/站立位吸气 CT 上的肺/叶/气道体积。
仰卧位/站立位吸气 CT 上总肺体积与 PFT 总肺活量和肺活量的相关系数分别为 0.887/0.920 和 0.711/0.781；仰卧位/站立位呼气 CT 上总肺体积与 PFT 功能残气量和残气量的相关系数分别为 0.676/0.744 和 0.713/0.739；仰卧位/站立位吸气 CT 上气道体积与 PFT 用力呼气 1 秒量的相关系数分别为 0.471/0.524。与仰卧位相比，站立位时双侧上叶和右下叶、双侧肺和气道体积的吸气/呼气均显著增加（3.6-21.2%增加，均 p<0.05）；然而，站立位时右中叶的吸气/呼气体积显著降低（分别降低 4.6%/15.9%，均 p<0.001）。
与仰卧 CT 相比，COPD 患者直立 CT 基于体积与 PFT 测量值的相关性更高。与其他叶和气道不同，右中叶的吸气/呼气体积在站立位时明显低于仰卧位。
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