Loubeyre P, Paret M, Revel D, Wiesendanger T, Brune J
Service de Radiologie, Hopital Cardiovasculaire et Pneumologique, Lyon, France.
Chest. 1996 Feb;109(2):360-5. doi: 10.1378/chest.109.2.360.
To evaluate, on thin-section CT scans, the prevalence of emphysema in patients with bronchiectasis and to correlate the results of thin-section CT scans with the results of pulmonary function tests, in order to question whether there was a particular functional test profile in this group of patients.
This is a retrospective study including 90 patients having both thin-section CT scans and pulmonary function tests for bronchiectasis. A CT scoring system was established for assessing the airway disease by the severity and extent of bronchiectasis and by the extent of emphysema. CT scans were reviewed independently by two reviewers and final interpretation was obtained by consensus. Results of thin-section CT scans were correlated with results of pulmonary function tests, including FEV1 and FEV1/FVC to assess air-way obstruction, total lung capacity and residual volume to assess air trapping, and diffusing capacity for carbon monoxide/alveolar volume (DCO/VA).
CT evidence of emphysema, which was noted in 45% of the patients (n = 41), was mainly localized in the same bronchopulmonary segments as bronchiectasis. The presence of emphysema was in relation to the extent and to the severity of bronchiectasis. Only eight patients with CT evidence of emphysema had functional evidence of emphysema (20%). When comparing the group of patients with CT evidence of emphysema with the group of patients with no CT evidence of emphysema, the group of patients with CT evidence of emphysema had significantly higher airflow obstruction and air trapping, had significantly lesser value of diffusing capacity, but with no decreased gas transfer (DCO/VA > 80%).
Our series suggests that there is a high prevalence of emphysema in patients with bronchiectasis. Emphysema that was not suggested using pulmonary function tests in most of the cases could explain in part the higher airway obstruction observed in the group of patients with CT evidence of emphysema. This study could support the suggestive notion that emphysema, which was mainly localized in bronchiectatic lobes, could be due to the inflammatory airway process.
通过薄层CT扫描评估支气管扩张患者肺气肿的患病率，并将薄层CT扫描结果与肺功能测试结果相关联，以探讨该组患者是否存在特定的功能测试特征。
这是一项回顾性研究，纳入了90例同时进行了支气管扩张的薄层CT扫描和肺功能测试的患者。建立了一种CT评分系统，通过支气管扩张的严重程度和范围以及肺气肿的范围来评估气道疾病。CT扫描由两名阅片者独立进行复查，并通过达成共识得出最终解读结果。薄层CT扫描结果与肺功能测试结果相关联，包括评估气道阻塞的FEV1和FEV1/FVC、评估气体潴留的肺总量和残气量，以及一氧化碳弥散量/肺泡容积（DCO/VA）。
45%（n = 41）的患者有CT证据显示肺气肿，主要位于与支气管扩张相同的支气管肺段。肺气肿的存在与支气管扩张的范围和严重程度相关。仅有8例有CT证据显示肺气肿的患者有肺气肿的功能证据（20%）。将有CT证据显示肺气肿的患者组与无CT证据显示肺气肿的患者组进行比较时，有CT证据显示肺气肿的患者组气流阻塞和气体潴留明显更高，弥散量明显更低，但气体转移无降低（DCO/VA > 80%）。
我们的系列研究表明支气管扩张患者中肺气肿的患病率较高。在大多数情况下，肺功能测试未提示的肺气肿可能部分解释了有CT证据显示肺气肿的患者组中观察到的更高气道阻塞。本研究可能支持这样一种提示性观点，即主要位于支气管扩张肺叶的肺气肿可能是由于气道炎症过程所致。
