Hansell D M, Wells A U, Rubens M B, Cole P J
Department of Radiology, Royal Brompton National Heart and Lung Hospital and Institute, London, England.
Radiology. 1994 Nov;193(2):369-74. doi: 10.1148/radiology.193.2.7972745.
To characterize areas of decreased attenuation on expiratory computed tomographic (CT) scans in patients with bronchiectasis.
CT scans were obtained at full inspiration and end expiration in 70 patients with chronic purulent sputum production. Inspiratory scans were scored at a lobar level for the extent of bronchiectasis, and inspiratory and expiratory scans were scored for the presence and extent of areas of decreased attenuation. Total lobar observations were analyzed (n = 840).
Bronchiectasis was identified in 434 of 840 lobar observations. The total decreased attenuation score was related to extent of bronchiectasis (r = .49; P < .001), independent of functional indexes. Negative correlations were found between forced expiratory volume in 1 second (FEV1) and total decreased attenuation score (P < .002) and FEV1 to forced vital capacity ratio (P < .004) but not with indexes of gas transfer.
Areas of decreased attenuation on expiratory CT scans are common in severe bronchiectasis. Such areas in lobes without overt bronchiectasis suggest that small airways disease may precede the development of bronchiectasis.
对支气管扩张症患者呼气期计算机断层扫描（CT）中衰减降低区域进行特征描述。
对70例有慢性脓性痰液生成的患者在深吸气末和呼气末进行CT扫描。吸气期扫描按肺叶水平对支气管扩张程度进行评分，吸气期和呼气期扫描对衰减降低区域的存在及范围进行评分。对全部肺叶观察结果进行分析（n = 840）。
在840次肺叶观察中，434次发现支气管扩张。总衰减降低评分与支气管扩张程度相关（r = 0.49；P < 0.001），与功能指标无关。1秒用力呼气量（FEV1）与总衰减降低评分（P < 0.002）以及FEV1与用力肺活量比值（P < 0.004）之间呈负相关，但与气体交换指标无关。
呼气期CT扫描中衰减降低区域在重度支气管扩张症中常见。在无明显支气管扩张的肺叶中出现此类区域提示小气道疾病可能先于支气管扩张症发生。
