title: Quantitative assessment of cross-sectional area of small pulmonary vessels in patients with COPD using inspiratory and expiratory MDCT.
abstract: OBJECTIVE
  Structural and functional changes in pulmonary vessels are prevalent at the initial stages of chronic obstructive pulmonary disease (COPD). These vascular alterations can be assessed using cross-sectional area (CSA) of small pulmonary vessels. However, neither in non-COPD smokers nor in COPD patients it has been defined whether the structural changes of pulmonary vessels detected by paired inspiratory and expiratory CT scans are associated with emphysematous changes. We quantified the CSA and low attenuation area (LAA) and evaluated the changes in these parameters in the inspiratory and expiratory phases.
  
  
  METHODS
  Fifty consecutive non-COPD smokers and COPD patients were subjected to multi detector-row CT and the percentage of vessels with a CSA less than 5 mm(2) as well as the percentage LAA for total lung area (%CSA<5, %LAA, respectively) were calculated.
  
  
  RESULTS
  The %CSA<5 correlated negatively with %LAA. The %CSA<5 was lower in COPD patients with emphysema as compared with non-COPD smokers and COPD patients with or without mild emphysema. In addition, the %CSA<5 was lower in the no/mild emphysema subgroup as compared with non-COPD smokers. The respiratory phase change of %CSA<5 in COPD patients was greater than that in non-COPD smokers.
  
  
  CONCLUSIONS
  The percentage of small pulmonary vessels decreased as emphysematous changes increase, and this decrease was observed even in patients with no/mild emphysema. Furthermore, respiratory phase changes in CSA were higher in COPD patients than in non-COPD smokers.
authors.affiliation: Department of Respirology, Graduate School of Medicine, Chiba University, Chiba 260-8670 Japan. matsuyuki_future@yahoo.co.jp
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Matsuura
authors.forename: Naoko
authors.initials: N
authors.lastname: Kawata
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Yanagawa
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sugiura
authors.forename: Yoriko
authors.initials: Y
authors.lastname: Sakurai
authors.forename: Misuzu
authors.initials: M
authors.lastname: Sato
authors.forename: Ken
authors.initials: K
authors.lastname: Iesato
authors.forename: Jiro
authors.initials: J
authors.lastname: Terada
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Sakao
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tada
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Tanabe
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Koichiro
authors.initials: K
authors.lastname: Tatsumi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D045853:Exhalation; D005260:Female; D006801:Humans; D001239:Inhalation; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging*; D011656:Pulmonary Emphysema / Q000150:complications / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Chronic obstructive pulmonary disease; Low attenuation area; Multi detector-row computed tomography; Small pulmonary vessels