대한영상의학회지 (Journal of the Korean Society of Radiology)

  • 제84권4호
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  • Pages.900-910
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  • 2023
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  • 1738-2637(pISSN)
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  • 2951-0805(eISSN)
대한영상의학회 (The Korean Society of Radiology)
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정상 흉부 단층촬영 검사에서 흡연 및 폐쇄성 폐질환 유무에 따른 정량화 검사 분석

Quantitative CT Analysis Based on Smoking Habits and Chronic Obstructive Pulmonary Disease in Patients with Normal Chest CT

  • 변정희 (전북대학교 의과대학 전북대학교병원 임상의학연구소-의생명연구원 영상의학과) ;
  • 진공용 (전북대학교 의과대학 전북대학교병원 임상의학연구소-의생명연구원 영상의학과) ;
  • 한영민 (전북대학교 의과대학 전북대학교병원 임상의학연구소-의생명연구원 영상의학과) ;
  • 최은정 (전북대학교 의과대학 전북대학교병원 임상의학연구소-의생명연구원 영상의학과) ;
  • 채금주 (전북대학교 의과대학 전북대학교병원 임상의학연구소-의생명연구원 영상의학과) ;
  • 박은혜 (전북대학교 의과대학 전북대학교병원 임상의학연구소-의생명연구원 영상의학과)
  • Jung Hee Byon (Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Gong Yong Jin (Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Young Min Han (Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Eun Jung Choi (Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Kum Ju Chae (Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital) ;
  • Eun Hae Park (Department of Radiology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital)
  • 투고 : 2022.09.26
  • 심사 : 2022.11.13
  • 발행 : 2023.07.01
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초록

목적 정상으로 보이는 chest CT를 정량화 분석하여 흡연 및 폐쇄성 폐질환(chronic obstructive pulmonary disease; 이하 COPD) 여부에 따른 차이가 있는지 확인하고자 하였다. 대상과 방법 2013년 1월부터 2014년 12월까지 chest CT가 정상이면서 정량화 분석이 있는 90명의 남자 환자[COPD 없는 비흡연자(n = 38)와 흡연자(n = 45), COPD 흡연자(n = 7)]를 대상으로 하였다. COPD 흡연자 7명을 대상으로 나이를 추출하여 환자-대조군 연구도 하위 분석하였다. Pi10, 왜도, 첨도, 평균감쇠계수, 저감쇠영역%와 같은 정령화 변수를 분석하였다. 결과 COPD가 없는 환자 중에서 흡연자의 Pi10 (4.176 ± 0.282, n = 45)이 비흡연자에 비해 약 0.1 mm 정도 두꺼웠고(4.070 ± 0.191, n = 38, p = 0.047), 흡연자의 왜도와 첨도(2.628 ± 0.484 and 6.448 ± 3.427)가 비흡연자보다 낮았다(2.884 ± 0.624, p = 0.038 and 8.594 ± 4.944, p = 0.027). COPD가 있는 흡연자들의 Pi10 (4.427 ± 0.437, n = 7)이 COPD가 없는 비흡연자들보다 약 0.4 mm 두꺼웠다(4.001 ± 0.108, n = 14, p = 0.005). 그러나 평균감쇠계수와 저감쇠영역%에서는 유의한 차이가 없었다. 결론 정상 chest CT를 보이더라도 QCT로 COPD의 유무와 상관없이 흡연자들의 소기도가 두꺼운 것을 알 수 있으며 이는 폐실질 변화보다 더 선행한다.

Purpose To assess normal CT scans with quantitative CT (QCT) analysis based on smoking habits and chronic obstructive pulmonary disease (COPD). Materials and Methods From January 2013 to December 2014, 90 male patients with normal chest CT and quantification analysis results were enrolled in our study [non-COPD never-smokers (n = 38) and smokers (n = 45), COPD smokers (n = 7)]. In addition, an age-matched cohort study was performed for seven smokers with COPD. The square root of the wall area of a hypothetical bronchus of internal perimeter 10 mm (Pi10), skewness, kurtosis, mean lung attenuation (MLA), and percentage of low attenuation area (%LAA) were evaluated. Results Among patients without COPD, the Pi10 of smokers (4.176 ± 0.282) was about 0.1 mm thicker than that of never-smokers (4.070 ± 0.191, p = 0.047), and skewness and kurtosis of smokers (2.628 ± 0.484 and 6.448 ± 3.427) were lower than never-smokers (2.884 ± 0.624, p = 0.038 and 8.594 ± 4.944, p = 0.02). The Pi10 of COPD smokers (4.429 ± 0.435, n = 7) was about 0.4 mm thicker than never-smokers without COPD (3.996 ± 0.115, n = 14, p = 0.005). There were no significant differences in MLA and %LAA between groups (p > 0.05). Conclusion Even on normal CT scans, QCT showed that the airway walls of smokers are thicker than never-smokers regardless of COPD and it preceded lung parenchymal changes.

키워드

과제정보

This study was supported by the research institute of clinical medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital.

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