Segmental Bronchial Diameter Measurement at Inspiration-Expiration Phase by Low-dose MSCT in Healthy Volunteers
International Journal of Biomedical Materials Research
Volume 7, Issue 2, December 2019, Pages: 72-77
Received: Feb. 13, 2019;
Accepted: Apr. 23, 2019;
Published: Aug. 30, 2019
Views 216 Downloads 37
Li He, Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, China
Qingyun Ren, Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, China
Zhai Liu, Department of Radiology, The First Hospital of Hebei Medical University, Shijiazhuang, China
Objective: This study aimed to evaluate the normal range of quantitative CT in measuring the airway diameter at inspiration-expiration phase using 3D imaging in healthy adults. Materials and Methods: 68 healthy volunteers, including 42 males and 26 females, with the mean age of 49.3 (SD14.7) years, had undergone low-dose CT scan at full inspiration and the end of expiration. All CT scans were performed within the range from the lung apices to the diaphragm, at a tube potential of 120kVp and an effective mAs of 60. Afterwards, all CT images were analyzed using the 3D software (FUJIFILM Corporation SYNAPSE), and the airway tree was generated according to the automated region-growing technique, which was perpendicular to the cross section measurement of the segmental bronchus in bilateral lower lobes. Meanwhile, the imaging of segmental bronchus was classified as at inspiration and expiration phase in male group, and at inspiration and expiration phase in female group. Moreover, the Din-L and Din-S of the segmental bronchus were analyzed quantitatively. Difference in the segmental bronchial diameter between the inspiration and expiration phase group with the same sex was evaluated with paired-t test, while that between the male and female groups was analyzed by a 2-tailed unpaired t test. In addition, the impact of age, height, weight and BMI on Din-L and Din-S was assessed through multiple linear regression analysis. Results: 378 segmental branches in the lower lobe of lung from male group and 234 from female group were shown using the low-dose multi-slice spiral CT (MSCT) scan. All segmental bronchi were detected automatically using the 3D software. Our results suggested that, Din-L and Din-S in segmental bronchus of both male and female groups at inspiration phase were larger than those at expiration phase; and those in male group were greater than those in female group at both inspiration and expiration phases (P < 0.01). Meanwhile, the average of Din-L and Din-S was markedly related to age at both inspiration and expiration phases. Conclusions: The normal reference values and the likely ranges are determined for segmental bronchus diameter in the lower lobe of adult lung at inspiration-expiration phase. The average of Din-L and Din-S is evidently correlated with age and sex at both inspiration and expiration phases. The segmental bronchus diameter at inspiration phase in adolescents is larger than that at expiration phase.
Segmental Bronchial Diameter Measurement at Inspiration-Expiration Phase by Low-dose MSCT in Healthy Volunteers, International Journal of Biomedical Materials Research.
Vol. 7, No. 2,
2019, pp. 72-77.
Naidich DP, Zinn WL, Ettenger NA, et al. Basilar segmental bronchi: thin-section CT evaluation [J]. Radiology, 1988, 169 (1): 11-16.
Matsuoka Y, Ookubo T, Ookubo K, et al Thin-section computed tomography of the bronchi: right middle lobe, left lingular division, and lower lobe [J]. Rinsho Hoshasen 1989, 34 (7): 799-803.
Zach J A, Jd Newell J, Schroeder J, et al. Quantitative CT of the Lungs and Airways in Healthy Non-smoking Adults [J]. Investigative Radiology, 2012, 47 (10): 596-602.
Hackx M, FRANCOTTE, Dorothée, Severo Garcia T, et al. Effect of Total Lung Capacity, Gender and Height on CT airways measurements [J]. The British Journal of Radiology, 2017, 90 (1076): 20160898.
Nambu A, Zach J, Schroeder J, et al. Quantitative computed tomography measurements to evaluate airway disease in chronic obstructive pulmonary disease: Relationship to physiological measurements, clinical index and visual assessment of airway disease [J]. European Journal of Radiology, 2016, 85 (11): 2144-2151.
Philip K, Oliver W, Wielpütz Mark O, et al. Quantitative CT detects changes in airway dimensions and air-trapping after bronchial thermoplasty for severe asthma [J]. European Journal of Radiology, 2018, 107 (8): 33-38.
Kuo W, Ciet P, Andrinopoulou E R, et al. Reference Values for Central Airway Dimensions on CT Images of Children and Adolescents [J]. AJR Am J Roentgenol, 2018, 210 (2): 423-430.
Mi W, Zhang C, Wang H, et al. Measurement and Analysis of the Tracheobronchial Tree in Chinese Population Using Computed Tomography [J]. PLOS ONE, 2015, 10 (6): e0130239.
Matsuoka S. Airway dimensions at inspiratory and expiratory multisection CT in chronic obstructive pulmonary disease: correlation with airflow limitation [J]. Radiology, 2008, 248 (3): 1042-1049.
Kloth C, Thaiss W M, Ditt H, et al. Segmental bronchi collapsibility: computed tomography-based quantification in patients with chronic obstructive pulmonary disease and correlation with emphysema phenotype, corresponding lung volume changes and clinical parameters [J]. Journal of Thoracic Disease, 2016, 8 (12): 3521-3529.
Chae EJ, Kim TB, Cho YS, et al. Airway Measurement for Airway Remodeling Defined by Post-Bronchodilator FEV1/FVC in Asthma: Investigation Using Inspiration-Expiration Computed Tomography [J]. Allergy Asthma Immunol Res, 2011, 3 (2): 111-117.
Xie X, Dijkstra AE, V onk JM, et al. Chronic respiratory symptoms associated with airway wall thickening measured by thin-slice low-dose CT [J]. AJR. 2014, 203 (4): W383-390.
Song S K, Jin G Y, Li Y Z, et al. CT Quantification of Lungs and Airways in Normal Korean Subjects: [J]. Korean Journal of Radiology, 2017, 18 (4): 739-748.
Karayama M, Inui N, Mori K, et al. Respiratory impedance is correlated with morphological changes in the lungs on three-dimensional CT in patients with COPD [J]. Scientific Reports, 2017, 7: 41709.
Scannel JG, Boston MD, Mass. A study of variations of the bronchopulmonary segments in the left upper lobe [J]. J Thorac Surg, 1947, 31: 530-537.
Boyden EA, Hamre CJ, Minn M. An analysis of variations in the bronchovascular patterns of the middle lobe in fifty dissected and twenty injcted lungs [J]. J Thorac Surg, 1951, 21 (2): 172-188.
Boyen EA. The nomenclature of the bronchopulmonary segments and their blood supply [J]. Dis Chest, 1961, 39 (1): 1-6.
Xie X, Dijkstra AE, Vonk JM, et al. Chronic respiratory symptoms associated with airway wall thickening measured by thin-slice low-dose CT [J]. AJR. 2014, 203 (4): W383-390.
Bauer C, Eberlein M, Beichel R R. Graph-Based Airway Tree Reconstruction From Chest CT Scans: Evaluation of Different Features on Five Cohorts [J]. IEEE Trans Med Imaging, 2015, 34 (5): 1063-1076.
Zou LG, Zhang XS, Yang H, et al. Quantitative CT study of segmental and subsegmental bronchi in normal subjects [J]. ChongQing Medicine, 2012, 4 (11): 8-10 (in Chinese).
Liu M, Yan WC, Yang Y, et al. Measurement of airway dimensions in children under 5y of age: a CT study with controlled ventitation [J]. Radiologic Practice, 2015, 30 (3) 275-278 (in Chinese).
CP Hersh, GR Washko, RS Estépar, et al. Paired inspiratory-expiratory chest CT scans to assess for small airways disease in COPD [J]. Respiratory Research, 2013, 14 (1): 42.
Kirby M, Yin Y, Tschirren J, et al. A Novel Method of Estimating Small Airway Disease Using Inspiratory-to-Expiratory Computed Tomography [J]. Respiration, 2017, 94 (4): 336-345.
Kubo T, Ohno Y, Nishino M, et al. Low dose chest CT protocol (50 mAs) as a routine protocol for comprehensive assessment of intrathoracic abnormality. [J]. European Journal of Radiology Open, 2016, 3 (C): 86-94.
Chen H, Chen G Q, Zeng Q S, et al. Quantitative Assessment of Airway Pathology in Subjects With COPD Using Low-Dose High-Resolution Computed Tomography. [J]. Respiratory Care, 2017, 62 (7): 953-962.
Lee JW, Son JS, Choi JW, et al. The comparison of the longs and diameters of main bronchi measured from two-dimensional and three-dimensional images in the same patients [J]. Korean J Anesthsiol. 2014, 66 (3): 189-194.