Low-dose CT measurements of airway dimensions and emphysema associated withairflow limitation in heavy smokers: a cross sectional study

Respiratory Research

Harry JM Groen¹  Michael Schmidt²  Bram van Ginneken⁵  Firdaus A Mohamed Hoesein⁴  Pieter Zanen⁴  Peter MA van Ooijen³  Matthijs Oudkerk³  Judith M Vonk⁶  Nick ten Hacken¹  Dirkje S Postma¹  Akkelies E Dijkstra¹ 

[1] University of Groningen, Department of Pulmonary Diseases, University MedicalCenter Groningen, GRIAC research institute, Groningen, the Netherlands;Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany;University of Groningen, Department of Radiology, University Medical CenterGroningen, Groningen, the Netherlands;Division of Heart & Lungs, University Medical Center Utrecht, Utrecht,the Netherlands;Department of Radiology, Radboud University Nijmegen Medical Centre,Nijmegen, the Netherlands;University of Groningen, Department of Epidemiology, University MedicalCenter Groningen, Groningen, the Netherlands

关键词: Emphysema;    Airflow limitation;    Smoking;    Respiratory symptoms;    Low-dose CT;    Airway dimensions;   

Others  :  796545
DOI  :  10.1186/1465-9921-14-11

 received in 2012-10-24, accepted in 2013-01-17,  发布年份 2013

【 摘 要 】

Background

Increased airway wall thickness (AWT) and parenchymal lung destruction both contribute to airflow limitation. Advances in computed tomography (CT) post-processing imaging allow to quantify these features. The aim of this Dutch population study is to assess the relationships between AWT, lung function, emphysema and respiratory symptoms.

Methods

AWT and emphysema were assessed by low-dose CT in 500 male heavy smokers, randomly selected from a lung cancer screening population. AWT was measured in each lung lobe in cross-sectionally reformatted images with an automated imaging program at locations with an internal diameter of 3.5 mm, and validated in smaller cohorts of patients. The 15^th percentile method (Perc15) was used to assess the severity of emphysema. Information about respiratory symptoms and smoking behavior was collected by questionnaires and lung function by spirometry.

Results

Median AWT in airways with an internal diameter of 3.5 mm (AWT_3.5) was 0.57 (0.44 - 0.74) mm. Median AWT in subjects without symptoms was 0.52 (0.41-0.66) and in those with dyspnea and/or wheezing 0.65 (0.52-0.81) mm (p<0.001). In the multivariate analysis only AWT_3.5 and emphysema independently explained 31.1%and 9.5%of the variance in FEV₁%predicted, respectively, after adjustment for smoking behavior.

Conclusions

Post processing standardization of airway wall measurements provides a reliable and useful method to assess airway wall thickness. Increased airway wall thickness contributes more to airflow limitation than emphysema in a smoking male population even after adjustment for smoking behavior.

【 授权许可】

   
2013 Dijkstra et al.; licensee BioMed Central Ltd.

【 图 表 】

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