Quantitative analysis in different phenotypes of chronic obstructive pulmonary disease by the paired inspiratory and expiratory high resolution CT
SHI Wei-ya1, HANG Jing-qing1, ZHANG Zhi-yong2, ZHANG Feng-ying1
1.Shanghai Putuo District People’s Hospital, Shanghai 200060, China;
2.Department of Radiology, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
Abstract：Objective: To study the differences of CT quantitative parameters in the three phenotypes of chronic obstructive pulmonary disease(COPD), and correlations with pulmonary function parameters, so as to ascertain the clinical feasibility of CT applicative parameters. Methods: Ninety one patients with stable COPD underwent the paired inspiratory and expiratory HRCT scans and pulmonary function tests. The subjects were classified into the three phenotypes according to the rank of emphysema and with or without the bronchial wall thickening: A phenotype, E phenotype and M phenotype. The differences of pulmonary function parameters and CT quantitative parameters(%LAA-950ins、%LAA-856exp、RVC-856to-950 and E/I-ratio MLD) in the three phenotypes of COPD were analyzed. The correlations between CT quantitative and pulmonary function parameters were evaluated. Results: There were three phenotypes in this study: A phenotype(n=50), E phenotype(n=23) and M phenotype(n=18). The values of FEV1, FEV1% and FEV1/FVC were reduced successively in the A phenotype, E phenotype and M phenotype. The values of %LAA-950ins, %LAA-856exp, RVC-856to-950 and E/I-ratio MLD were increased successively in the A phenotype, E phenotype and M phenotype. In the A phenotype group, %LAA-950ins had no correlation with pulmonary function parameters, %LAA-856exp, RVC-856to-950 and E/I-ratio MLD had statistically negative correlations with pulmonary function parameters separately. Among them, E/I-ratio MLD had the strongest negative correlation with FEV1%(γ＝-0.588, P＝0.000). In the E phenotype and M phenotype groups, CT quantitative parameters had statistically significant negative correlations with pulmonary function parameters(P＜0.01). RVC-856to-950 had the strongest negative correlation with FEV1(γ＝-0.669, P＝0.000). Conclusion: CT quantitative parameters were different in the three phenotypes of COPD. CT index of emphysema(%LAA-950ins) and CT indexes of gas trapping (%LAA-856exp, RVC-856to-950 and E/I-ratio MLD) could be used as effective parameters for evaluating pulmonary function of COPD.
史维雅1，杭晶卿1，张志勇2，张锋英1. 呼吸气双相HRCT成像对不同COPD表型的定量评估[J]. 中国临床医学影像杂志, 2018, 29(5): 329-332.
SHI Wei-ya1, HANG Jing-qing1, ZHANG Zhi-yong2, ZHANG Feng-ying1. Quantitative analysis in different phenotypes of chronic obstructive pulmonary disease by the paired inspiratory and expiratory high resolution CT. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(5): 329-332.
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2018, Vol. 29 
