A quantification of the lung surface area in emphysema using computed tomography.

Quantitative analysis of computed tomography (CT) has been combined with a stereologically based histologic analysis of lung structure to assess regional lung inflation and the structural features of the lung parenchyma. In this study, CT measurements of lung inflation were compared with histologic estimates of surface area in order to develop prediction equations that allow lung surface to volume ratio and surface area to be predicted from an analysis of the CT scan. The results show that mild emphysema is associated with an increase in lung volume and a reduction in surface to volume ratio, whereas surface area and tissue weight were only decreased in severe disease. The CT predicted surface to volume ratio correlated with histology, and both predicted and measured surface areas correlated with the diffusing capacity. We conclude that this CT analysis can be used to monitor the progression of emphysematous lung destruction in individual patients, and to assess the impact of both surgical and medical treatments for emphysema.

[1]  J. H. Comroe,et al.  A rapid plethysmographic method for measuring thoracic gas volume: a comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects. , 1956, The Journal of clinical investigation.

[2]  Goldman Hi,et al.  Respiratory function tests; normal values at median altitudes and the prediction of normal results. , 1959 .

[3]  W. Thurlbeck.  Internal surface area and other measurements in emphysema , 1967, Thorax.

[4]  J. Hogg,et al.  Site and nature of airway obstruction in chronic obstructive lung disease. , 1968, The New England journal of medicine.

[5]  J. Hogg,et al.  Elastic properties of the centrilobular emphysematous space. , 1969, The Journal of clinical investigation.

[6]  J. Hogg,et al.  Regional lung volume and pleural pressure gradient estimated from lung density in dogs. , 1969, Journal of applied physiology.

[7]  R M Gardner,et al.  Reference spirometric values using techniques and equipment that meet ATS recommendations. , 2015, The American review of respiratory disease.

[8]  L M Cruz-Orive,et al.  Sampling designs for stereology * , 1981, Journal of microscopy.

[9]  P. Haber,et al.  Alveolar size as a determinant of pulmonary distensibility in mammalian lungs. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[10]  H. Anderson,et al.  Single breath diffusing capacity in a representative sample of the population of Michigan, a large industrial state. Predicted values, lower limits of normal, and frequencies of abnormality by smoking history. , 1983, The American review of respiratory disease.

[11]  L. Hedlund,et al.  Evaluating Lung Density by Computed Tomography , 1983 .

[12]  K. Coppin,et al.  Variability in measurements of pressure-volume curves in normal subjects. , 1985, The American review of respiratory disease.

[13]  J. Hogg,et al.  Exponential analysis of the pressure-volume curve. Correlation with mean linear intercept and emphysema in human lungs. , 1988, The American review of respiratory disease.

[14]  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.

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

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

[17]  R. Crystal,et al.  Alpha 1-antitrypsin deficiency, emphysema, and liver disease. Genetic basis and strategies for therapy. , 1990, The Journal of clinical investigation.

[18]  W. MacNee,et al.  Quantifying Emphysema by CT Scanning , 1991 .

[19]  F. Lagier,et al.  Prevalence of latex allergy in operating room nurses. , 1992, The Journal of allergy and clinical immunology.

[20]  W. MacNee,et al.  Microscopic and macroscopic measurements of emphysema: relation to carbon monoxide gas transfer. , 1992, Thorax.

[21]  D M Hyde,et al.  Lung morphometry: a new generation of tools and experiments for organ, tissue, cell, and molecular biology. , 1993, The American journal of physiology.

[22]  P. Knauf,et al.  WW-781, a potent reversible inhibitor of red cell Cl- flux, binds to band 3 by a two-step mechanism. , 1993, The American journal of physiology.

[23]  W. Thurlbeck.  Lung structure and function in cigarette smokers. , 1994, Thorax.

[24]  P De Vuyst,et al.  Comparison of computed density and macroscopic morphometry in pulmonary emphysema. , 1995, American journal of respiratory and critical care medicine.

[25]  P. Paré,et al.  Measurement of lung expansion with computed tomography and comparison with quantitative histology. , 1995, Journal of applied physiology.

[26]  R. Rogers,et al.  Improvement in pulmonary function and elastic recoil after lung-reduction surgery for diffuse emphysema. , 1996, The New England journal of medicine.

[27]  R. Rogers,et al.  Lung reduction surgery in chronic obstructive lung disease. , 1996, The Medical clinics of North America.

[28]  K P Whittall,et al.  Quantification of idiopathic pulmonary fibrosis using computed tomography and histology. , 1997, American journal of respiratory and critical care medicine.

[29]  D. Massaro,et al.  Retinoic acid treatment abrogates elastase-induced pulmonary emphysema in rats , 1997, Nature Medicine.

[30]  M. Akl,et al.  Prevalence of latex sensitization in a hospital employee population. , 1997, Annals of Allergy, Asthma & Immunology.

[31]  D. Beezhold,et al.  Incidence of latex sensitization among latex glove users. , 1998, The Journal of allergy and clinical immunology.

[32]  Merrett,et al.  The prevalence of immunoglobulin E antibodies to the proteins of rubber (Hevea brasiliensis) latex and grass (Phleumpratense) pollen in sera of British blood donors , 1999, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.