Associations of airway tree to lung volume ratio on computed tomography with lung function and symptoms in chronic obstructive pulmonary disease

HANDLE オープンアクセス
  • 田辺, 直也
    Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University
  • 佐藤, 晋
    Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University
  • 小熊, 毅
    Department of Respiratory Medicine, Graduate School of Medicine
  • 島, 寛
    Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University
  • 佐藤, 篤靖
    Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University
  • 室, 繁郎
    Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University
  • 平井, 豊博
    Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University

抄録

Background: Decreased airway lumen size and increased lung volume are major structural changes in chronic obstructive pulmonary disease (COPD). However, even though the outer wall of the airways is connected with lung parenchyma and the mechanical properties of the parenchyma affect the behaviour of the airways, little is known about the interactions between airway and lung sizes on lung function and symptoms. The present study examined these effects by establishing a novel computed tomography (CT) index, namely, airway volume percent (AWV%), which was defined as a percentage ratio of the airway tree to lung volume. Methods: Inspiratory chest CT, pulmonary function, and COPD Assessment Tests (CAT) were analysed in 147 stable males with COPD. The whole airway tree was automatically segmented, and the percentage ratio of the airway tree volume in the right upper and middle-lower lobes to right lung volume was calculated as the AWV% for right lung. Low attenuation volume % (LAV%), total airway count (TAC), luminal area (Ai), and wall area percent (WA%) were also measured. Results: AWV% decreased as the Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric grade increased (p < 0.0001). AWV% was lower in symptomatic (CAT score ≥ 10) subjects than in non-symptomatic subjects (p = 0.036). AWV% was more closely correlated with forced expiratory volume in 1 s (FEV1) and ratio of residual volume to total lung capacity (RV/TLC) than Ai, Ai to lung volume ratio, and volume of either the lung or the airway tree. Multivariate analyses showed that lower AWV% was associated with lower FEV1 and higher RV/TLC, independent of LAV%, WA%, and TAC. Conclusions: A disproportionally small airway tree with a relatively large lung could lead to airflow obstruction and gas trapping in COPD. AWV% is an easily measured CT biomarker that may elucidate the clinical impacts of the airway-lung interaction in COPD.

収録刊行物

詳細情報

  • CRID
    1050282813269013888
  • NII論文ID
    120006629161
  • ISSN
    14659921
    1465993X
  • HANDLE
    2433/241361
  • 本文言語コード
    en
  • 資料種別
    journal article
  • データソース種別
    • IRDB
    • CiNii Articles

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