Quantitative CT Analysis Of The Effects Of Airway Remodeling And Emphysema On Airflow Limitation In COPD

Objective:To quantitatively analyze the changes of airway remodeling and emp hysema in patients with chronic obstructive pulmonary disease(COPD)by multi-slice spiral CT(MSCT),and explore their correlation with airflow limitation in COPD.Methods:Thirty-three patients with COPD were enrolled and underwent pulmonary function tests(PFT)and inspiratory phase multi-slice spiral CT scan.The Zio CT Pulmonary Analysis COPD automatic analysis software was used to measure the T/D ratio and WA% of RB1、RB4、RB10、LB1、LB10,as well as the degree of emphysema(LAV%)in the whole lung and each lung lobe.Spss22.0 statistical analysis software was used to explore the correlation among the airway parameters of five bronchial segments and their sub-segments,the emphysema of the whole lung and each lung lobe,and the pulmonary function text.Correlation tests were performed using Pearson(in accordance with normal distribution)or spearman(non-normal distribution).COPD patients were divided into two groups of mild(grade 1,2)and severe(grade 3,4),and the independent sample t test was used to compare the differences between the two groups.Results:The WA% and T/D ratio values of RB1,RB4,RB10,LB1 and LB10 segments and their sub-segments had no correlation with FEV1pred%.LAV% of the whole lung was significantly correlated with FEV1pred% and FEV1/FVC.LAV% of Each lobe was correlated with FEV1/FVC.LAV% of the lower lung lobe had the strongest correlation with FEV1/FVC.LAV% of the lower right lung lobe had the strongest correlation with FEV1pred%,followed by the middle right lung lobe and lower left lung lobe.There were significant differences in LAV% of the whole lung,lower lung lobe and middle right lung lobe between the two groups.Conclusion:The airway parameters of RB1,RB4,RB10,LB1 and LB10 may not be related to pulmonary function.Quantitative MSCT imaging can effectively evaluate emphysema in COPD,and the emphysema of each lung lobe are related to pulmonary function,especially in both lower lung lobes.In addition,emphysema also played an important role in evaluating the severity of COPD.