Quantitative assessment of emphysema, air trapping, and airway thickening on computed tomography.
The severity of chronic obstructive pulmonary disease (COPD) is evaluated not only by airflow limitation but also by factors such as exercise capacity and body mass index. Recent advances in CT technology suggest that it might be a useful tool for evaluating the severity of the disease components of COPD. The aim of this study is to evaluate the correlation between the parameters measured on volumetric CT, including the extent of emphysema, air trapping, and airway thickening, and clinical parameters. CT scans were performed in 34 patients with COPD at full inspiration and expiration. We used in-house software to measure CT parameters, including volume fraction of emphysema (V(950)), mean lung density (MLD), CT air trapping index (CT ATI), segmental bronchial wall area (WA), lumen area (LA), and wall area percent (WA%). We found that the CT parameters were correlated with the pulmonary function test (PFT) results, body mass index (BMI), the modified Medical Research Council Dyspnea scale (MMRC scale), the six-minute-walk distance (6MWD), and the BODE index. V(950 insp) correlated to the BMI, FEV(1), 6MWD, and the BODE index. The CT ATI correlated with the physiologic ATI (VC-FVC) (R=0.345, p=0.045) and the MMRC scale (R=0.532, p=0.001). There was a positive correlation between the WA% and the BMI (R=0.563, p<0.001). MLD(exp) showed the strongest correlation with the BODE index (R= -0.756, p<0.001). We conclude that the severity of emphysema and air trapping measured on CT correlated with the PFT parameters 6MWD and BMI.
Lee
Young Kyung
YK
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Research Institute of Radiology, 388-1, Pungnap-dong, Songpa-ku, Seoul, 138-736, Korea.|Department of Radiology, Bundang CHA Hospital, University of Pocheon Jungmoon College of Medicine, 183-8 Yatap-dong, Bundang-Ku, Seongnam-City, Gyeonggi-Do, 463-712, Korea.
Oh
Yeon-Mok
YM
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Research Institute of Radiology, 388-1, Pungnap-dong, Songpa-ku, Seoul, 138-736, Korea.
Lee
Ji-Hyun
JH
Department of Internal Medicine, Bundang CHA Hospital, University of Pocheon Jungmoon College of Medicine, 183-8 Yatap-dong, Bundang-Ku, Seongnam-City, Gyeonggi-Do, 463-712, Korea.
Kim
Eun Kyung
EK
Department of Internal Medicine, Bundang CHA Hospital, University of Pocheon Jungmoon College of Medicine, 183-8 Yatap-dong, Bundang-Ku, Seongnam-City, Gyeonggi-Do, 463-712, Korea.
Lee
Jin Hwa
JH
Department of Internal Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Korea.
Kim
Namkug
N
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Research Institute of Radiology, 388-1, Pungnap-dong, Songpa-ku, Seoul, 138-736, Korea.
Seo
Joon Beom
JB
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Research Institute of Radiology, 388-1, Pungnap-dong, Songpa-ku, Seoul, 138-736, Korea. seojb@amc.seoul.kr.
Lee
Sang Do
SD
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Research Institute of Radiology, 388-1, Pungnap-dong, Songpa-ku, Seoul, 138-736, Korea. sdlee@amc.seoul.kr.
D000368:Aged; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*