Coxson H O, Hogg J C, Mayo J R, Behzad H, Whittall K P, Schwartz D A, Hartley P G, Galvin J R, Wilson J S, Hunninghake G W
University of British Columbia Pulmonary Research Laboratory, St. Paul's Hospital, Vancouver, Canada.
Am J Respir Crit Care Med. 1997 May;155(5):1649-56. doi: 10.1164/ajrccm.155.5.9154871.
We used computed tomography (CT) and histologic analysis to quantify lung structure in idiopathic pulmonary fibrosis (IPF). CT scans were obtained from IPF and control patients and lung volumes were estimated from measurements of voxel size, and X-ray attenuation values of each voxel. Quantitative estimates of lung structure were obtained from biopsies obtained from diseased and normal CT regions using stereologic methods. CT density was used to calculate the proportion of tissue and air, and this value was used to correct the biopsy specimens to the level of inflation during the CT scan. The data show that IPF is associated with a reduction in airspace volume with no change in tissue volume or weight compared with control lungs. Lung surface area decreased two-thirds (p < 0.001) and mean parenchymal thickness increased tenfold (p < 0.001). An exudate of fluid and cells was present in the airspace of the diseased lung regions and the number of inflammatory cells, collagen, and proteoglycans was increased per 100 g of tissue in IPF. We conclude that IPF reorganized lung tissue content causing a loss of airspace and surface area without increasing the total lung tissue.
我们使用计算机断层扫描（CT）和组织学分析来量化特发性肺纤维化（IPF）中的肺结构。从IPF患者和对照患者获取CT扫描图像，并根据体素大小测量值和每个体素的X射线衰减值估算肺体积。使用体视学方法从患病和正常CT区域获取的活检组织中获得肺结构的定量估计值。利用CT密度计算组织和空气的比例，并使用该值将活检标本校正至CT扫描期间的充气水平。数据显示，与对照肺相比，IPF与气腔体积减少相关，而组织体积或重量无变化。肺表面积减少了三分之二（p < 0.001），平均实质厚度增加了十倍（p < 0.001）。患病肺区域的气腔中存在液体和细胞渗出物，IPF中每100克组织中的炎症细胞、胶原蛋白和蛋白聚糖数量增加。我们得出结论，IPF重组了肺组织成分，导致气腔和表面积减少，而未增加肺组织总量。
