Low-Dose Whole-Chest Dynamic CT for the Assessment of Large Airway Collapsibility in Patients with Suspected Tracheobronchial Instability.

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-10-01 DOI:10.1148/ryct.240041
Arved Bischoff, Oliver Weinheimer, Anja Dutschke, Roman Rubtsov, Hans-Ulrich Kauczor, Daniela Gompelmann, Ralf Eberhardt, Franziska Trudzinski, Claus P Heussel, Felix J F Herth, Mattias Heinrich, Fenja Falta, Mark O Wielpütz
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Abstract

Purpose To quantify tracheal collapsibility using low-dose four-dimensional (4D) CT and to compare visual and quantitative 4D CT-based assessments with assessments from paired inspiratory-expiratory CT, bronchoscopy, and spirometry. Materials and Methods The authors retrospectively analyzed 4D CT examinations (January 2016-December 2022) during shallow respiration in 52 patients (mean age, 66 years ± 12 [SD]; 27 female, 25 male), including 32 patients with chronic obstructive pulmonary disease (mean forced expiratory volume in 1 second percentage predicted [FEV1%], 50% ± 27), with suspected tracheal collapse. Paired CT data were available for 27 patients and bronchoscopy data for 46 patients. Images were reviewed by two radiologists in consensus, classifying patients into three groups: 50% or greater tracheal collapsibility, less than 50% collapsibility, or fixed stenosis. Changes in minimal tracheal lumen area, tracheal volume, and lung volume from inspiration to expiration were quantified using YACTA software. Tracheal collapsibility between groups was compared employing one-way analysis of variance (ANOVA). For related samples within one group, ANOVA with repeated measures was used. Spearman rank order correlation coefficient was calculated for collapsibility versus pulmonary function tests. Results At 4D CT, 25 of 52 (48%) patients had tracheal collapsibility of 50% or greater, 20 of 52 (38%) less than 50%, and seven of 52 (13%) had fixed stenosis. Visual assessment of 4D CT detected more patients with collapsibility of 50% or greater than paired CT, and concordance was 41% (P < .001). 4D CT helped identify more patients with tracheal collapsibility of 50% or greater than did bronchoscopy, and concordance was 74% (P = .39). Mean collapsibility of tracheal lumen area and volume at 4D CT were higher for 50% or greater visually assessed collapsibility (area: 53% ± 9 and lumen: 52% ± 10) compared with the less than 50% group (27% ± 9 and 26% ± 6, respectively) (P < .001), whereas both tracheal area and volume were stable for the fixed stenosis group (area: 16% ± 12 and lumen: 21% ± 11). Collapsibility of tracheal lumen area and volume did not correlate with FEV1% (rs = -0.002 to 0.01, P = .99-.96). Conclusion The study demonstrated that 4D CT is feasible and potentially more sensitive than paired CT for central airway collapse. Expectedly, FEV1% was not correlated with severity of tracheal collapsibility. Keywords: CT-Quantitative, Tracheobronchial Tree, Chronic Obstructive Pulmonary Disease, Imaging Postprocessing, Thorax Supplemental material is available for this article. © RSNA, 2024.

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低剂量全胸动态 CT 用于评估疑似气管支气管不稳患者的大气管塌陷度。
目的 使用低剂量四维 (4D) CT 量化气管塌陷度,并将基于四维 CT 的视觉和定量评估与成对吸气-呼气 CT、支气管镜检查和肺活量测定的评估进行比较。材料与方法 作者回顾性分析了 52 名患者(平均年龄为 66 岁 ± 12 [SD];27 名女性,25 名男性)浅呼吸时的四维 CT 检查结果(2016 年 1 月至 2022 年 12 月),其中包括 32 名慢性阻塞性肺病患者(平均每秒用力呼气容积预测值百分比 [FEV1%],50%±27),疑似气管塌陷。27 名患者获得了配对 CT 数据,46 名患者获得了支气管镜数据。两名放射科医生在达成共识后对图像进行了审查,并将患者分为三组:气管塌陷度大于或等于 50%、塌陷度小于 50%、固定狭窄。使用 YACTA 软件对最小气管腔面积、气管容积和肺容积从吸气到呼气的变化进行量化。采用单因素方差分析(ANOVA)比较组间气管塌陷度。对于同一组内的相关样本,则采用重复测量方差分析。计算塌缩度与肺功能测试的斯皮尔曼秩相关系数。结果 在四维 CT 上,52 名患者中有 25 人(48%)的气管塌陷度大于或等于 50%,52 人中有 20 人(38%)的气管塌陷度小于 50%,52 人中有 7 人(13%)的气管有固定狭窄。与配对 CT 相比,4D CT 的目视评估发现了更多气管塌陷度为 50% 或以上的患者,一致性为 41% (P < .001)。与支气管镜检查相比,四维 CT 能帮助发现更多气管塌陷度为 50% 或以上的患者,一致性为 74% (P = .39)。与低于 50% 组(分别为 27% ± 9 和 26% ± 6)相比,目测塌缩度为 50% 或以上组(面积:53% ± 9,管腔:52% ± 10)的四维 CT 平均塌缩度气管管腔面积和容积更高(P < .001),而固定狭窄组的气管面积和容积均保持稳定(面积:16% ± 12,管腔:21% ± 11)。气管腔面积和容积的塌陷度与 FEV1% 无关(rs = -0.002 至 0.01,P = .99-.96)。结论 该研究表明,四维 CT 是可行的,而且可能比成对 CT 对中心气道塌陷更敏感。预计 FEV1% 与气管塌陷的严重程度无关。关键词CT定量、气管支气管树、慢性阻塞性肺病、成像后处理、胸廓 本文有补充材料。© RSNA, 2024.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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