Yang C F, Wu M T, Chiang A A, Lai R S, Chen C, Tiao W M, McLoud T C, Wang J S, Pan H B
Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan ROC.
AJR Am J Roentgenol. 1997 Apr;168(4):1045-50. doi: 10.2214/ajr.168.4.9124113.
An outbreak of Sauropus androgynus-associated bronchiolitis obliterans occurred in Taiwan in the summer of 1995. We undertook a study of the correlation between high-resolution CT findings and pulmonary function testing in patients from this outbreak.
We evaluated inspiratory-expiratory high-resolution CT scans of 24 patients with S. androgynus-associated bronchiolitis obliterans. The presence of bronchiectasis was assessed by two visual scores (a bronchial dilatation score and a bronchiectasis extent score). Extent of air-trapping was assessed visually and given a score. We also used computer software to assess the extent of air-trapping and generate scores of dynamic attenuation. Spirometry, plethysmography, and diffusion capacity of each patient were also obtained.
All four scores had statistically significant correlation with forced expiratory volume in 1 sec (FEV1) (p < .05 for both bronchiectasis scores; p < .001 for both air-trapping scores). The two air-trapping scores had statistically significant correlation with forced vital capacity and diffusion capacity. We found the scores for dynamic attenuation had the greatest correlation with FEV1 (r = .85). We also found that mosaic attenuation was notable on expiratory CT scans alone in nine patients (type 1 air-trapping) and on both inspiratory and expiratory CT scans in 15 patients (type 2 air-trapping). In the latter group, FEV1 was significantly lower (p < .01).
Findings from high-resolution CT of air-trapping were more important than findings of bronchiectasis when correlating pulmonary function with S. androgynus-associated bronchiolitis obliterans. Type 2 air-trapping suggested a more severe air-flow obstruction than did type 1. Scores for quantitative attenuation generated by computer software were helpful in assessing air-trapping and correlating it with pulmonary function. These findings may apply to patients with bronchiolitis obliterans from other causes.
1995年夏季台湾发生了一起与守宫木相关的闭塞性细支气管炎疫情。我们对此次疫情中患者的高分辨率CT表现与肺功能测试之间的相关性进行了研究。
我们评估了24例与守宫木相关的闭塞性细支气管炎患者的吸气-呼气高分辨率CT扫描。通过两种视觉评分（支气管扩张评分和支气管扩张范围评分）评估支气管扩张的存在情况。通过视觉评估空气潴留程度并给出评分。我们还使用计算机软件评估空气潴留程度并生成动态衰减评分。同时获取了每位患者的肺活量测定、体积描记法和弥散功能数据。
所有四项评分与第1秒用力呼气量（FEV1）均具有统计学显著相关性（两种支气管扩张评分的p值均<0.05；两种空气潴留评分的p值均<0.001）。两种空气潴留评分与用力肺活量和弥散功能具有统计学显著相关性。我们发现动态衰减评分与FEV1的相关性最大（r = 0.85）。我们还发现，仅在呼气CT扫描上出现马赛克衰减的有9例患者（1型空气潴留），在吸气和呼气CT扫描上均出现马赛克衰减的有15例患者（2型空气潴留）。在后一组中，FEV1显著更低（p < 0.01）。
在将肺功能与守宫木相关的闭塞性细支气管炎进行关联时，高分辨率CT的空气潴留表现比支气管扩张表现更重要。2型空气潴留提示气流阻塞比1型更严重。计算机软件生成的定量衰减评分有助于评估空气潴留并将其与肺功能相关联。这些发现可能适用于其他原因导致的闭塞性细支气管炎患者。
