title: Small pulmonary vascular alteration and acute exacerbations of COPD: quantitative computed tomography analysis.
abstract: The morphologic alterations of pulmonary small vessels measured by computed tomography (CT) have been used to evaluate chronic obstructive pulmonary disease (COPD). However, the relationship between small pulmonary vascular alteration and acute exacerbations of COPD (AECOPD) is not well understood. The aim of this study was to evaluate the cross-sectional area (CSA) of small pulmonary vessel alterations measured on CT images and investigate its relationship with the COPD severity staged by the degree of airflow limitation and the occurrence of AECOPD. We retrospectively reviewed CT scans, clinical characteristics, and pulmonary function test results of 153 patients with COPD. All the patients were divided into AECOPD and non-AECOPD group according to the COPD staging and pulmonary function test results. The percentages of the total CSA less than 5 mm(2) and equal to 5-10 mm(2) over the lung area (%CSA<5 and %CSA5-10, respectively) were measured. The %CSA<5 steadily decreased in relation to the increase of COPD severity. In addition, %CSA<5 of the AECOPD group was significantly lower than that of the non-AECOPD group (0.41±0.13 versus 0.68±0.18, P<0.001), and the optimal cutoff value was 0.56 (sensitivity, 0.863; specificity, 0.731). Therefore, small pulmonary vascular alteration, as measured by %CSA<5, could indicate not only the degree of COPD severity, but also the occurrence of AECOPD.
authors: Department of Radiology.
authors: Zhiyue
authors: Z
authors: Wang
authors: Department of Respiratory, The First Affiliated Hospital of Nanjing Medical University.
authors: Xuesong
authors: X
authors: Chen
authors: Department of Respiratory, The First Affiliated Hospital of Nanjing Medical University.
authors: Kouying
authors: K
authors: Liu
authors: Department of Respiratory, The First Affiliated Hospital of Nanjing Medical University.
authors: Weiping
authors: W
authors: Xie
authors: Department of Respiratory, The First Affiliated Hospital of Nanjing Medical University.
authors: Hong
authors: H
authors: Wang
authors: Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.
authors: Yongyue
authors: Y
authors: Wei
authors: Department of Radiology.
authors: Lijun
authors: L
authors: Tang
authors: Department of Radiology.
authors: Yinsu
authors: Y
authors: Zhu
mesh_terms: D000368:Aged; D019540:Area Under Curve; D000072226:Computed Tomography Angiography; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013147:Spirometry; D014797:Vital Capacity
keywords: acute exacerbation of chronic obstructive pulmonary disease; computed tomography; cross-sectional area of small pulmonary vessels