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Correlation between quantitative CT findings and pulmonary function tests in pulmonary alveolar proteinosis

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
Issue:
5
DOI:
10.3760/cma.j.issn.1674-1927.2009.05.004
Key Word:
肺泡蛋白沉着症;体层摄影术;X线计算机;定量;肺功能检查;相关分析;Pulmonary alveolar proteinosis;Tomography;X-ray computed;Quantitative analysis;Pulmonary function tests;Correlation analysis

Abstract: Objective To evaluate the use and correlation of quantitative CT findings and pulmonary function tests (PFTs) before and after whole lung lavage (WLL) in pulmonary alveolar proteinosis (PAP). Methods Correlation between findings of 37 pulmonary CT scans and contemporary PFTs was analyzed in 20 patients with PAP. A comparison was performed in 15 PAP patients between their quantitative CT findings before and after a total of 20 sessions of WLL (19 of both-lung lavage and 1 of single-lung lavage). Parameters of quantitative CT analysis included maximal end-tidal total lung volume, total lung weight, airspace volume, mean lung volume, mean lung density and the ratio of airspace volume over total lung volume. PFTs were used to measure forced vital capacity (FVC), forced expiratory volume in one second (FEV_1), FEV_1/FVC, peak expiratory flow(PEF), diffusion capacity for carbon monoxide of the lung(D_LCO) and carbon monoxide diffusing capacity per liter of alveolar(D_LCO/VA). The Chinese adult normal reference values of pulmonary function were regarded as the normal predictive values, and the ratios of measured values/normal predictive values were used for correlation analysis. Results (1) Total lung weight showed correlation with FVC% and FEV_1% (both P<0.05). Airspace volume showed correlation with FVC% , (FEV_1/FVC) %, D_LCO%, (D_LCO/VA) % (All/P<0.05). Mean lung volume, mean lung density and airspace volume/total lung volume were correlated well with FVC%, FEV_1%, (FEV_1/FVC)%, PEF%, D_LCO%, (D_LCO/VA)% (all P<0.05). The highest correlation was found between airspace volume/total lung volume and D_LCO% , (D_LCO/VA)% (r=0.725, 0.725, P=0.000, 0.000, respectively). (2) Following WLL, significant changes were found in total lung weight [(1613±459)g vs (1293±351)g, P=0.000], mean lung density [(0.5178±0.15) g/ml vs (0.4312±0.10) g/ml, P=0.000], mean lung volume [(1.216±0.70) ml/g vs (1.573±0.61) ml/g, P=0.001] and airspace volume/total lung volume (0.5110±0.14 vs 0.6005±0.10, P= 0.000). The total lung volume was positively correlated with the airspace volume before and after WLL (r= 0.911, P=0.000). Conclusions Spiral CT scanning with maximal end-tidal volume can provide pulmonary quantitative analysis which shows good correlation with PFTs, and therefore may be an effective method for quantitative pulmonary function study. Significant changes in total lung weight, mean lung density and airspace volume/total lung volume are observed by quantitative CT after WLL.

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