title: Assessment of lobar perfusion in smokers according to the presence and severity of emphysema: preliminary experience with dual-energy CT angiography.
abstract: The purpose of the study was to assess pulmonary perfusion on a lobar level in smokers using dual-energy computed tomography (CT). Forty-seven smokers and ten non-smokers underwent a dual-energy multi-detector CT angiogram of the chest that allowed automatic quantification of emphysema and determination of the iodine content at the level of the microcirculation (i.e. "perfusion imaging"). Emphysema was present in 37 smokers and absent in ten smokers. Smokers with an upper lobe predominance of emphysema (n = 8) had: (1) significantly lower attenuation enhancement values in the upper lobes compared with smokers without emphysema; (2) the lobes with the most severe emphysematous changes had a statistically significantly higher percentage of emphysema (p = 0.0001) and lower mean attenuation enhancement values (p = 0.0001) than the ipsilateral lobes with less severe emphysema, matching parenchymal destruction; (3) a correlation was found between the difference in percentage of emphysema between the upper and lower lobes and the difference in attenuation attenuation enhancement values in the corresponding lobes (p = 0.0355; r = -0.54). Regional alterations of lung perfusion can be depicted by dual-energy CT in smokers with predominant emphysema.
authors.affiliation: Department of Thoracic Imaging, Hospital Calmette, University Center of Lille, Lille, France.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pansini
authors.forename: Martine
authors.initials: M
authors.lastname: Remy-Jardin
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Faivre
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schmidt
authors.forename: Alexis
authors.initials: A
authors.lastname: Dejardin-Bothelo
authors.forename: Thierry
authors.initials: T
authors.lastname: Perez
authors.forename: Valérie
authors.initials: V
authors.lastname: Delannoy
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.forename: Jacques
authors.initials: J
authors.lastname: Remy
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D004646:Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D010865:Pilot Projects; D011652:Pulmonary Circulation; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed / Q000379:methods