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2013 ; 201
(3
): W460-70
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Relationships between airflow obstruction and quantitative CT measurements of
emphysema, air trapping, and airways in subjects with and without chronic
obstructive pulmonary disease
#MMPMID23971478
Schroeder JD
; McKenzie AS
; Zach JA
; Wilson CG
; Curran-Everett D
; Stinson DS
; Newell JD Jr
; Lynch DA
AJR Am J Roentgenol
2013[Sep]; 201
(3
): W460-70
PMID23971478
show ga
OBJECTIVE: This study evaluates the relationships between quantitative CT (QCT)
and spirometric measurements of disease severity in cigarette smokers with and
without chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS:
Inspiratory and expiratory CT scans of 4062 subjects in the Genetic Epidemiology
of COPD (COPDGene) Study were evaluated. Measures examined included emphysema,
defined as the percentage of low-attenuation areas?-950 HU on inspiratory CT,
which we refer to as "LAA-950I"; air trapping, defined as the percentage of
low-attenuation areas?-856 HU on expiratory CT, which we refer to as "LAA-856E";
and the inner diameter, inner and outer areas, wall area, airway wall thickness,
and square root of the wall area of a hypothetical airway of 10-mm internal
perimeter of segmental and subsegmental airways. Correlations were determined
between spirometry and several QCT measures using statistics software (SAS,
version 9.2). RESULTS: QCT measurements of low-attenuation areas correlate
strongly and significantly (p<0.0001) with spirometry. The correlation between
LAA-856E and forced expiratory volume in 1 second (FEV1) and the ratio of FEV1 to
forced vital capacity (FVC) (r=-0.77 and -0.84, respectively) is stronger than
the correlation between LAA-950I and FEV1 and FEV1/FVC (r=-0.67 and r=-0.76).
Inspiratory and expiratory volume changes decreased with increasing disease
severity, as measured by the Global Initiative for Chronic Obstructive Pulmonary
Disease (GOLD) staging system (p<0.0001). When airway variables were included
with low-attenuation area measures in a multiple regression model, the model
accounted for a statistically greater proportion of variation in FEV1 and
FEV1/FVC (R2=0.72 and 0.77, respectively). Airway measurements alone are less
correlated with spirometric measures of FEV1 (r=0.15 to -0.44) and FEV1/FVC
(r=0.19 to -0.34). CONCLUSION: QCT measurements are strongly associated with
spirometric results showing impairment in smokers. LAA-856E strongly correlates
with physiologic measurements of airway obstruction. Airway measurements can be
used concurrently with QCT measures of low-attenuation areas to accurately
predict lung function.