Bronchial measurement with three-dimensional quantitative thin-section CT in patients with cystic fibrosis.
OBJECTIVE
To prospectively compare bronchial measurements obtained with three-dimensional quantitative thin-section computed tomography (CT) with those obtained with thin-section CT scores in the assessment of the severity of pulmonary cystic fibrosis (CF).


METHODS
Ethics committee approval was obtained. Sixteen patients with CF (mean age, 26.6 years; range, 18-42 years) and five healthy volunteers (mean age, 27.4 years; range, 21-44 years) gave written informed consent, underwent multi-detector row CT and a pulmonary function test (PFT), and were divided into three groups: group A, healthy volunteers; group B, patients with mild CF (forced expiratory volume in 1 second [FEV(1)] > 80%); and group C, patients with severe CF (FEV(1) < 80%). Two observers obtained thin-section CT scores with eight scoring systems. Bronchial cross-sectional wall area (WA), lumen area (LA), airway area, and wall thickness (WT) were measured with customized software and were normalized on the basis of subject body surface. Morphologic characteristics, PFT results, thin-section CT scores, and quantitative measurements were compared among the three groups with analysis of variance. Correlations among bronchial measurements, PFT results, and CT scores were calculated with the Spearman correlation coefficient.


RESULTS
Thin-section CT scores were different between group C and either group A or group B (P < .05). WA and WT were significantly different among all groups (P < .05). Interscore correlations and correlations between bronchial parameters and scores were high (r > 0.89, P < .0001). Scores, WA, and WT were significantly correlated with PFT obstructive indexes (P < .047).


CONCLUSIONS
WA and WT assessed with dedicated software on multi-detector row CT images allow evaluation of the severity of pulmonary CF.
Montaudon
Michel
M
Laboratory of Cellular Respiratory Physiology, Université Bordeaux 2, Bordeaux, France.
Berger
Patrick
P
Cangini-Sacher
Agathe
A
de Dietrich
Gabriel
G
Tunon-de-Lara
José Manuel
JM
Marthan
Roger
R
Laurent
François
F
D000293:Adolescent; D000328:Adult; D019412:Anatomy, Cross-Sectional; D001830:Body Surface Area; D001980:Bronchi / Q000473:pathology*; D001995:Bronchography / Q000379:methods*; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008450:Maximal Midexpiratory Flow Rate / Q000502:physiology; D011446:Prospective Studies; D012115:Residual Volume / Q000502:physiology; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014109:Total Lung Capacity / Q000502:physiology; D014797:Vital Capacity / Q000502:physiology