Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Quantification of Emphysema with a Three-Dimensional Chest CT Scan: Correlation with the Visual Emphysema Scoring on Chest CT, Pulmonary Function Tests and Dyspnea Severity

삼차원 흉부 CT를 이용한 폐기종의 정량적 분석: 폐기종 지수, 폐기능 검사 및 호흡곤란 정도와의 상관관계

  • Park, Hyun-Jeong (Department of Radiology, Soonchunhyang University Seoul Hospital) ;
  • Hwang, Jung-Hwa (Department of Radiology, Soonchunhyang University Seoul Hospital)
  • 박현정 (순천향대학교 서울병원 영상의학과) ;
  • 황정화 (순천향대학교 서울병원 영상의학과)
  • Published : 2011.09.01
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Abstract

Purpose: We wanted to prospectively evaluate the correlation between the quantification of emphysema using 3D CT densitometry with the visual emphysema score, pulmonary function tests (PFT) and the dyspnea score in patients with chronic obstructive pulmonary disease (COPD). Materials and Methods: Non-enhanced chest CT with 3D reconstruction was performed in 28 men with COPD (age 54-88 years). With histogram analysis, the total lung volume, mean lung density and proportion of low attenuation lung volume below predetermined thresholds were measured. The CT parameters were compared with the visual emphysema score, the PFT and the dyspnea score. Results: A low attenuation lung volume below -950 HU was well correlated with the DLco and $FEV_{1}$/FVC. A Low attenuation lung volume below -950 HU and -930 HU was correlated with visual the emphysema score. A low attenuation lung volume below -950 HU was correlated with the dyspnea score, although the correlations between the other CT parameters and the dyspnea score were not significant. Conclusion: Objective quantification of emphysema using 3D CT densitometry was correlated with the visual emphysema score. A low attenuation lung volume below -950 HU was correlated with the DLco, the $FEV_{1}$/FVC and the dyspnea score.

목적: 만성폐쇄성폐질환(Chronic Obstructive Pulmonary Disease; 이하 COPD) 환자에서 삼차원 CT를 이용한 폐기종의 정량적 분석을 시행하여 육안적 폐기종 지수, 폐기능 검사 및 호흡곤란 지수와의 상관성을 알아보고자 하였다. 대상과 방법: COPD로 진단된 28명의 환자를 대상으로 흉부 CT 및 삼차원 재구성을 시행하였다. 히스토그램을 분석하여 전폐 용적, 폐 감쇄도에 따른 분포 및 평균 감쇄도를 구하였으며 특정 감쇄도 이하에 해당하는 폐 용적의 백분율을 분석하였다. CT 지표들과 육안적 폐기종 지수, 폐기능 검사 지표들 및 호흡곤란 지수 간의 상관성을 분석하였다. 결과: 특정 역치 이하에 해당하는 폐 용적과 폐기능의 분석에서 -950 HU와 -930 HU를 역치로 하였을 때 $FEV_{1}$/FVC와 DLco가 유의한 상관성을 보였으며 육안적 폐기종 지수 역시 유사한 결과를 보였다. 육안적 폐기종 지수는 폐기능 검사 중 DLco와 유의한 상관성을 보였으며 호흡곤란 지수는 CT 역치값 -950 HU와 유의한 상관성을 보였다. 결론: 삼차원 CT 재구성을 이용한 폐기종의 정량적 분석은 DLco 및 $FEV_{1}$/FVC와 밀접한 상관관계를 보이며 -950 HU 이하의 폐 용적과 높은 상관성을 보였다. 육안적 폐기종 지수는 소프트웨어를 이용한 정량적 분석과 비교하여 임상적 지표들과 낮은 상관성을 보였다. -950 HU 이하의 폐 영역이 호흡곤란 지수와 상관성이 있는 것으로 나타났으나 그 외 CT 지표들은 유의한 상관성을 보이지 않았다.

Keywords

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