Relationship between CT air trapping criteria and lung function in small airway impairment quantification

BMC Pulmonary Medicine

Hélène Vernhet-Kovacsik³  Jacques Mercier⁶  Pascal Chanez¹  Isabelle Vachier⁵  Maurice Hayot⁶  François Klein³  Nicolas Molinari⁴  Arnaud Bourdin⁵  Grégory Marin⁴  Sébastien Bommart² 

[1] Respiratory Disease Department, CHU Marseille, Marseille, France;INSERM U 1046 Université Montpellier 1, Montpellier 2, Montpellier, France;Radiology Department, CHU Montpellier, 371 avenue Doyen Gaston Giraud 34295, Montpellier cedex 05, France;Statistics Department CHU Montpellier, Montpellier, France;Respiratory Disease Department, CHU Montpellier, Montpellier, France;Clinical Physiology Department, CHU Montpellier, Montpellier, France

关键词: Software-assisted CT quantification;    Biomarker;    Single breath nitrogen test;    Bronchiole;    Air trapping;   

Others  :  866547
DOI  :  10.1186/1471-2466-14-29

 received in 2013-08-29, accepted in 2014-02-14,  发布年份 2014

【 摘 要 】

Background

Small airways are regarded as the elective anatomic site of obstruction in most chronic airway diseases. Expiratory computed tomography (CT) is increasingly used to assess obstruction at this level but there is no consensus regarding the best quantification method. We aimed to evaluate software-assisted CT quantification of air trapping for assessing small airway obstruction and determine which CT criteria better predict small airway obstruction on single breath nitrogen test (SBNT).

Methods

Eighty-nine healthy volunteers age from 60 to 90 years old, underwent spirometrically-gated inspiratory (I) and expiratory (E) CT and pulmonary function tests (PFTs) using SBNT, performed on the same day. Air trapping was estimated using dedicated software measuring on inspiratory and expiratory CT low attenuation area (LAA) lung proportion and mean lung density (MLD). CT indexes were compared to SBNT results using the Spearman correlation coefficient and hierarchical dendrogram analysis. In addition, receiver operating characteristic (ROC) curve analysis was performed to determine the optimal CT air-trapping criterion.

Results

43 of 89 subjects (48,3%) had dN2 value above the threshold defining small airway obstruction (i.e. 2.5% N2/l). Expiratory to inspiratory MLD ratio (r = 0.40) and LAA for the range −850 -1024 HU (r = 0.29) and for the range −850 -910 HU (r = 0.37) were positively correlated with SBNT results. E/I _MLD was the most suitable criterion for its expression. Expiratory to inspiratory MLD ratio (E/I _MLD) showed the highest AUC value (0.733) for small airway obstruction assessment.

Conclusion

Among all CT criteria, all correlating with small airway obstruction on SBNT, E/I _MLD was the most suitable criterion for its expression in asymptomatic subjects with mild small airway obstruction

Trial registration

Registered at Clinicaltrials.gov, identifier: NCT01230879.

【 授权许可】

   
2014 Bommart et al.; licensee BioMed Central Ltd.

【 图 表 】

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