4.3 Article

Characteristic features of pulmonary function test, CT volume analysis and MR perfusion imaging in COPD patients with different HRCT phenotypes

Journal

CLINICAL RESPIRATORY JOURNAL
Volume 8, Issue 1, Pages 45-54

Publisher

WILEY
DOI: 10.1111/crj.12033

Keywords

chronic obstructive pulmonary disease; CT quantization; MR perfusion imaging; phenotype; pulmonary function test

Funding

  1. Youth Fund of the National Natural Science Foundation of China [81000602]
  2. Natural Science Foundation of Shanghai [10ZR1438900]
  3. National Natural Science Foundation of China [81171333, 30970800]

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IntroductionComputed tomography (CT) and magnetic resonance imaging (MRI) can provide detailed anatomic structures and quantitative function information for chronic obstructive pulmonary disease (COPD). ObjectivesTo prospectively clarify characteristics of pulmonary function test (PFT), CT volume parameters and magnetic resonance (MR) perfusion imaging in COPD patients with different high-resolution computed tomography (HRCT) phenotypes. Methods Sixty-two patients performed PFT, CT and MR perfusion imaging. COPD was classified into three phenotypes according to HRCT quantitative findings: A, E and M phenotype. Total lung volume (TLV), total emphysema volume (TEV) and emphysema index (EI) were quantitated by HRCT. In cases of perfusion defects (PDs), the shape and size were evaluated. The contrast between the normal lung and PDs was quantified by calculating their signal intensity ratio (R-SI=SIPD/SInormal). The correlation was performed between PFT, CT and MR perfusion. ResultsThere were 42 A phenotype, 9 E phenotype and 11 M phenotype. There was significant difference in forced expiratory volume in 1s (FEV1)/forced vital capacity (FVC) between A and M phenotype (P<0.05). TEV and EI of A phenotype (0.40.4L and 8.0%+/- 4.3%) were lower than those of E (1.0 +/- 0.3L and 18.6%+/- 3.2%) or M phenotype (0.9 +/- 0.2L and 17.5%+/- 1.7%). MR perfusion images showed circumscribed or diffuse patchy PDs. R-SI of A phenotype was higher than that of E phenotype (20.3%+/- 8.5% vs 11.8%+/- 5.4%; P=0.006). TEV and EI were moderate negatively correlated with diffusion function parameters. R-SI was strongly correlated with FEV1% (A) and FEV1/FVC (M). FEV1/FVC was strongly correlated with TEV or EI (E). ConclusionThere were different features and correlations between PFT, CT volume and MR perfusion in different phenotype, indicating each phenotype may have novel imaging method guiding clinical management.

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