Quantitative assessment of emphysema distribution in smokers and patients with alpha1-antitrypsin deficiency.
Respir Med
; 100(1): 94-100, 2006 Jan.
Article
em En
| MEDLINE
| ID: mdl-15882941
ABSTRACT
INTRODUCTION:
Identification of upper lobe emphysema is mandatory before lung volume reduction surgery (LVRS). Here we introduce a CT-based objective model for describing the distribution of different types of emphysema.METHODS:
Fifty COPD patients were included in the study. Half had alpha1-antitrypsin deficiency (alpha1-COPD) and the rest had smoking-induced emphysema (usual COPD). All patients were scanned 3 times. The relative area of emphysema in each CT slice was plotted against table position, and the cranio-caudal distribution was calculated as the slope of the regression line.RESULTS:
The variation in slopes within a patient was much less than the variation in slopes between patients (P<0.0001). There was a significant difference between slopes in the alpha1-COPD and the usual COPD groups (P<0.0001). In the alpha1-COPD group, 24/25 patients had lower lobe emphysema. In the usual COPD group, 4 patients had upper lope predominance, 5 patients had heterogeneous distributions, and 16 patients had lower lobe predominance.CONCLUSIONS:
The majority of patients with smoking-related emphysema have a homogeneous distribution and lower lobe predominance although not as noticeable as in alpha1-antitrypsin deficiency. An objective and quantitative method for determining the distribution of emphysema should be applied when selecting candidates for LVRS.
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Base de dados:
MEDLINE
Assunto principal:
Enfisema Pulmonar
/
Fumar
/
Tomografia Computadorizada por Raios X
/
Deficiência de alfa 1-Antitripsina
/
Doença Pulmonar Obstrutiva Crônica
Tipo de estudo:
Etiology_studies
/
Evaluation_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article