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Effect of inspiration on airway dimensions measured in maximal inspiration CT images of subjects without airflow limitation.

Abstract：

OBJECTIVES:To study the effect of inspiration on airway dimensions measured in voluntary inspiration breath-hold examinations. METHODS:961 subjects with normal spirometry were selected from the Danish Lung Cancer Screening Trial. Subjects were examined annually for five years with low-dose CT. Automated software was utilized to segment lungs and airways, identify segmental bronchi, and match airway branches in all images of the same subject. Inspiration level was defined as segmented total lung volume (TLV) divided by predicted total lung capacity (pTLC). Mixed-effects models were used to predict relative change in lumen diameter (ALD) and wall thickness (AWT) in airways of generation 0 (trachea) to 7 and segmental bronchi (R1-R10 and L1-L10) from relative changes in inspiration level. RESULTS:Relative changes in ALD were related to relative changes in TLV/pTLC, and this distensibility increased with generation (p < 0.001). Relative changes in AWT were inversely related to relative changes in TLV/pTLC in generation 3--7 (p < 0.001). Segmental bronchi were widely dispersed in terms of ALD (5.7 ± 0.7 mm), AWT (0.86 ± 0.07 mm), and distensibility (23.5 ± 7.7%). CONCLUSIONS:Subjects who inspire more deeply prior to imaging have larger ALD and smaller AWT. This effect is more pronounced in higher-generation airways. Therefore, adjustment of inspiration level is necessary to accurately assess airway dimensions. KEY POINTS:Airway lumen diameter increases and wall thickness decreases with inspiration. The effect of inspiration is greater in higher-generation (more peripheral) airways. Airways of generation 5 and beyond are as distensible as lung parenchyma. Airway dimensions measured from CT should be adjusted for inspiration level.

journal_name

Eur Radiol

journal_title

European radiology

authors

Petersen J,Wille MM,Rakêt LL,Feragen A,Pedersen JH,Nielsen M,Dirksen A,de Bruijne M

doi

10.1007/s00330-014-3261-3

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

2319-25

issue

eissn

0938-7994

issn

1432-1084

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Effect of inspiration on airway dimensions measured in maximal inspiration CT images of subjects without airflow limitation.