Measurement of lung density by means of quantitative CT scanning. A study of correlations with pulmonary function tests.

In recent years, much attention has been given to the role of CT in detecting and quantitating pulmonary emphysema. We measured CT lung density in 45 patients undergoing a diagnostic work-up and compared this with pulmonary function tests. The CT lung densities measured with the sector method and with the whole lung method were very highly correlated with each other (r = 0.96, p less than 0.001), and measurements at TLC systematically gave a lower density than those at FRC (p less than 0.001). Also, CT density measurements at TLC and even more so at FRC correlated well with pulmonary function indices of airway obstruction and of hyperinflation, but not with indices that are considered more specific for emphysema (single breath DCO, static lung compliance) We conclude that CT lung-density gives a good reflection of the degree of hyperinflation, ie, enlargement of distal airways, but is not sensitive to detect whether or not this is associated with emphysema.

[1]  R. G. Fraser,et al.  A COMPARISON BETWEEN CLINICAL, ROENTGENOLOGIC, FUNCTIONAL AND MORPHOLOGIC CRITERIA IN CHRONIC BRONCHITIS, EMPHYSEMA, ASTHMA AND BRONCHIECTASIS , 1970 .

[2]  G Gamsu,et al.  Pulmonary function abnormalities in patients with CT-determined emphysema. , 1987, Journal of computer assisted tomography.

[3]  P. Paré,et al.  The diagnosis of emphysema. A computed tomographic-pathologic correlation. , 1986, The American review of respiratory disease.

[4]  V L Roggli,et al.  Centrilobular emphysema: CT-pathologic correlation. , 1986, Radiology.

[5]  N J Morrison,et al.  Quantitation of emphysema by computed tomography using a "density mask" program and correlation with pulmonary function tests. , 1990, Chest.

[6]  E. C. Hammond,et al.  Relation of smoking and age to emphysema. Whole-lung section study. , 1972, The New England journal of medicine.

[7]  W. Thurlbeck,et al.  The National Institutes of Health Intermittent Positive-Pressure Breathing Trial: pathology studies. IV. The Destructive index. , 1989, The American review of respiratory disease.

[8]  P H Nath,et al.  Detection of emphysema with computed tomography. Correlation with pulmonary function tests and chest radiography. , 1988, Investigative radiology.

[9]  N J Morrison,et al.  Limitations of computed tomography in the assessment of emphysema. , 1989, The American review of respiratory disease.

[10]  F D Thomas,et al.  Density patterns in the normal lung as determined by computed tomography. , 1980, Radiology.

[11]  I. Greaves,et al.  Elastic behavior and structure of normal and emphysematous lungs post mortem. , 2015, The American review of respiratory disease.

[12]  G. Laszlo,et al.  Computed tomography in pulmonary emphysema. , 1982, Clinical radiology.

[13]  E C McCullough,et al.  The unreliability of CT numbers as absolute values. , 1982, AJR. American journal of roentgenology.

[14]  Comparison of single breath carbon monoxide diffusing capacity and pressure-volume curves in detecting emphysema. , 1990, The American review of respiratory disease.

[15]  R H Hruban,et al.  High resolution computed tomography of inflation-fixed lungs. Pathologic-radiologic correlation of centrilobular emphysema. , 1987, The American review of respiratory disease.

[16]  N J Morrison,et al.  Pulmonary capillary blood volume in emphysema. , 1990, The American review of respiratory disease.

[17]  D. Flenley,et al.  Pulmonary hemodynamics, gas exchange, and the severity of emphysema as assessed by quantitative CT scan in chronic bronchitis and emphysema. , 1989, The American review of respiratory disease.

[18]  B Jonson,et al.  Measurement of pulmonary density by means of X-ray computerized tomography. Relation to pulmonary mechanics in normal subjects. , 1986, Chest.

[19]  J. Nadel,et al.  Physiologic diagnosis of subclinical emphysema. , 2015, The American review of respiratory disease.

[20]  Nikkila Ea.  Letter: Serum high-density-lipoprotein and coronary heart-disease. , 1976 .

[21]  The radiology of emphysema. , 1983 .

[22]  H Nishitani,et al.  The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores. , 1990, The American review of respiratory disease.

[23]  W. Thurlbeck,et al.  The National Institutes of Health Intermittent Positive-Pressure Breathing trial: pathology studies. II. Correlation between morphologic findings, clinical findings, and evidence of expiratory air-flow obstruction. , 1985, The American review of respiratory disease.

[24]  Thurlbeck Wm.  The incidence of pulmonary emphysema, with observations on the relative incidence and spatial distribution of various types of emphysema. , 1963 .

[25]  M. Demedts,et al.  Early emphysema. Ten years' evolution. , 1988, Chest.

[26]  H Oeser,et al.  Measurement of Lung Density by Computed Tomography , 1978, Journal of computer assisted tomography.

[27]  J. Best,et al.  DIAGNOSIS OF PULMONARY EMPHYSEMA BY COMPUTERISED TOMOGRAPHY , 1984, The Lancet.

[28]  N. Müller,et al.  "Density mask". An objective method to quantitate emphysema using computed tomography. , 1988, Chest.

[29]  L. Liotta,et al.  Elastic behavior of postmortem human lungs: effects of aging and mild emphysema. , 1975, Journal of applied physiology.

[30]  L. North,et al.  Lung recoil pressure, airway resistance, and forced flows related to morphologic emphysema. , 2015, The American review of respiratory disease.

[31]  J. Best,et al.  CT measurements of lung density in life can quantitate distal airspace enlargement--an essential defining feature of human emphysema. , 1988, The American review of respiratory disease.

[32]  R. Mauceri,et al.  Computed tomography of the lung. , 1978, Radiology.