Division for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU) and Asklepios Medical Center; Munich-Gauting, Gauting, 82131, Germany.
Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive; Helmholtz Center Munich; Member of the German Lung Research Center (DZL), Munich, 81377, Germany.
Int J Chron Obstruct Pulmon Dis. 2024 Jul 1;19:1515-1529. doi: 10.2147/COPD.S458905. eCollection 2024.
The aim of this study was to evaluate the association between computed tomography (CT) quantitative pulmonary vessel morphology and lung function, disease severity, and mortality risk in patients with chronic obstructive pulmonary disease (COPD).
Participants of the prospective nationwide COSYCONET cohort study with paired inspiratory-expiratory CT were included. Fully automatic software, developed in-house, segmented arterial and venous pulmonary vessels and quantified volume and tortuosity on inspiratory and expiratory scans. The association between vessel volume normalised to lung volume and tortuosity versus lung function (forced expiratory volume in 1 sec [FEV]), air trapping (residual volume to total lung capacity ratio [RV/TLC]), transfer factor for carbon monoxide (TLCO), disease severity in terms of Global Initiative for Chronic Obstructive Lung Disease (GOLD) group D, and mortality were analysed by linear, logistic or Cox proportional hazard regression.
Complete data were available from 138 patients (39% female, mean age 65 years). FEV, RV/TLC and TLCO, all as % predicted, were significantly (p < 0.05 each) associated with expiratory vessel characteristics, predominantly venous volume and arterial tortuosity. Associations with inspiratory vessel characteristics were absent or negligible. The patterns were similar for relationships between GOLD D and mortality with vessel characteristics. Expiratory venous volume was an independent predictor of mortality, in addition to FEV.
By using automated software in patients with COPD, clinically relevant information on pulmonary vasculature can be extracted from expiratory CT scans (although not inspiratory scans); in particular, expiratory pulmonary venous volume predicted mortality.
NCT01245933.
本研究旨在评估慢性阻塞性肺疾病（COPD）患者 CT 定量肺血管形态与肺功能、疾病严重程度和死亡风险之间的关系。
本研究纳入了前瞻性全国性 COSYCONET 队列研究中的具有吸气-呼气 CT 配对的患者。使用内部开发的全自动软件对动脉和静脉肺血管进行分割，并对吸气和呼气扫描的容积和迂曲度进行定量。分析血管容积与肺容积的比值和迂曲度与肺功能（1 秒用力呼气量 [FEV]）、空气潴留（残气量与肺总量比 [RV/TLC]）、一氧化碳转移系数（TLCO）、全球慢性阻塞性肺疾病倡议（GOLD）D 组疾病严重程度以及死亡率之间的关系，采用线性、逻辑或 Cox 比例风险回归分析。
从 138 例患者（39%为女性，平均年龄 65 岁）中获得了完整的数据。FEV、RV/TLC 和 TLCO 均以预测值的百分比表示，与呼气期血管特征（主要为静脉容积和动脉迂曲度）显著相关（p < 0.05）。与吸气期血管特征无相关性或相关性可忽略不计。静脉容积与 GOLD D 和死亡率之间的关系也呈现相似的模式。除了 FEV 外，呼气期静脉容积还是死亡率的独立预测因素。
在 COPD 患者中使用自动化软件，可以从呼气 CT 扫描中提取与临床相关的肺血管信息（尽管不能从吸气 CT 扫描中提取）；特别是呼气期肺静脉容积可以预测死亡率。
NCT01245933。
