Correlation between the findings of expiratory high resolution computed tomography, respiratory function tests and tracheal index in chronic obstructive pulmonary disease

Yıl 2012, Cilt: 39 Sayı: 1, 42 - 48, 01.03.2012

Ozan Kurtulgan Ahmet Mete Meral Uyar

https://doi.org/10.5798/diclemedj.0921.2012.01.0092

Öz

Objectives: In this study we aimed to investigate the relationship between expiratory HRCT findings, tracheal index (TI) and pulmonary function tests in patients with chronic obstructive pulmonary disease (COPD). Materials and methods: Sixty patients diagnosed with COPD in our hospital, department of pulmonary medicine, and 65 subjects complaining of cough with normal pulmonary function tests as a control group were enrolled in the study. All subjects were evaluated with HRCT. HRCT and pulmonary function tests were performed in same day and FEV1, FVC, FEV1/FVC values were recorded. Pearson Chi-Square, Independent Samples T test, and Mann Whitney U test were used for statistical evaluation. Results: Subjects\' mean age was 55.44&plusmn;10.22 years. Bronchiectasis, bronchial wall thickening, emphysema, centri-lobular bronchiolar thickening and air trapping were significantly higher in COPD group than control group. In patient group, TI values were lower than control group (p < 0.001). Also there was moderate negative relationship between TI and age (p = 0.00, r = -0.48). Conclusions: Expiratory HRCT findings and TI values show various degrees of relationship with pulmonary function test results in patients with COPD. Despite normal pulmonary function tests, pathological changes can be detected in expiratory HRCT scans.

Anahtar Kelimeler

COPD, high resolution computed tomography, pulmonary function test.

Kronik obstrüktif akciğer hastalığında ekspiratuar yüksek rezolüsyonlu bilgisayarlı tomografi bulguları ile trakeal indeks ve solunum fonksiyon testleri arasındaki ilişki

Öz

Amaç: Çalışmamızda kronik obstrüktif akciğer hastalığı
(KOAH) olan olgularda ekspiratuvar Yüksek Rezolüsyonlu
Bilgisayarlı Tomografi (YRBT) bulguları ve trakeal indeks
(Tİ) ile solunum fonksiyon testleri (SFT) arasındaki
ilişkinin saptanması amaçlandı.
Gereç ve yöntem: Hastanemiz Göğüs Hastalıkları Bölü-
münde tanısı konulan 60 KOAH’lı hasta grubu ile kliniğe
öksürük şikayeti ile başvuran SFT değerleri normal olan
65 hasta kontrol grubu olarak çalışmaya dahil edildi. Tüm
olguların akciğer parankimi ekspiratuar YRBT ile değerlendirildi.
Her olguya YRBT incelemesi ile aynı günde SFT
yapıldı ve FEV1, FVC, FEV1/FVC değerleri kaydedildi.
Bulgular: Olguların ortalama yaşı 55,44±10,22 yıl idi.
KOAH grubunda bronşektazi (B), bronş duvar kalınlaş-
ması (BDK), amfizem (A), sentrilobüler bronşioler kalınlaşmalar
(SBK) ve hava hapsi (HH) kontrol grubuna göre
anlamlı olarak yüksek bulundu (p < 0,001). Hasta grubunda
Tİ değerleri kontrol grubuna kıyasla anlamlı olarak
düşük bulundu (p < 0,001). Ayrıca Tİ değerleri ile yaş arasında
orta düzeyde negatif yönlü anlamlı bir ilişki bulundu
(p=0,000, r = -0,48).
Sonuç: KOAH’lı hastalarda ekspiratuar YRBT bulguları
ve Tİ değerleri, solunum fonksiyon testleri ile değişik
derecelerde korelasyon göstermektedir. SFT normal olmasına
rağmen, ekspiratuar YRBT kesitlerinde patolojik
değişiklikler saptanabilmektedir.

Anahtar Kelimeler

KOAH, yüksek rezolüsyonlu bilgisayarlı tomografi, solunum fonksiyon testi.

Kaynakça

• Stern EJ, Frank MS. CT of the lung in patients with pulmo- nary emphysema; diagnosis, quantification, and correlation with pathologic and physiologic findings. Am J Roentgenol 1994;162(4): 791-8.
• American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am J Respir Crit Care Med 1995;152(5): 77-120.
• Global Initiative of Chronic Obstructive Lung Disease; Global strategy for diagnosis, management, prevention of chronic obstructive pulmonary disease updated 2008.
• Yıldırım N. KOAH patogenezi. Ed: S. Umut, N. Yıldırım Kronik Obstrüktif Akciğer Hastalığı (KOAH). Ed. İstanbul: Turgut yayıncılık; 2005:41-58.
• Eda S, Kubo K, Fujimoto K, Matsuzawa Y, Sekiguchi M, Sakai F. The relation between expiratory chest CT using he- lical CT and pulmonary function tests in emphysema. Am J Respir Crit Care Med 1997;155(4):1290-4.
• Gleb AF, Gold WM, Wright RR. Physiologic diagnosis of subclinic emphysema. Am Rev Respir Dis 1973;107(1):50- 63.
• Petty TL, Silver GW, Stanford RE. Mild amphysema is assıciated eith reduced elastic recoil and increased lung size but not air-flow limitation. Am Rev Respir Dis 1987;136(4):867-71.
• Mochizuki T, Nakajima H, Kokubu F, Kushihashi T, Ada- chi M. Evalution of emphysema in patients with reversible airway obstruction using high-resolution CT. Chest 1997; 112(6):1522-6.
• Kuwano K, Matsuba K, Ikeda T, Murakami J, Araki A, Nishi- tani H et al. The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores. Am Rev Respir Dis 1990;141(1):169-78.
• Koç Z, Bayram M, Ekinci E. Semptomatik amfizem olgula- rında yüksek rezolüsyonlu BT: Solunum fonksiyon testleri ve konvansiyonel BT ile karşılaştırma. Tanısal ve Girişim- sel Radyoloji 1994;1:132-7.
• Webb WR, Stern EJ, Kanth N, Gamsu G. Dynamic pul- monary CT: Findings in healthy adultman. Radiology 1993;186(1):117-24.
• Lucidarme O, Coche E, Cluzel P, Mourey-Gerosa 1, How- arth N, Grenier P. Expiratory CT scans for chronic airway disease: Correlation with pulmonary function test results. AJR 1998;170(2):301-7.
• Park CS, Muller NL, Worthy SA, Kim JS. Awadhi N, Fitzgerald M. Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin- section CT fındings. Radiology 1997;203(2):361-7.
• Kauczor HU, Hast J, Heussel CP, Schlegel J, Mildenberger P, Thelen M. Focal airtrapping at expiratory high- resolu- tion CT: comparision with pulmonary function tests. Eur Radiol 2000;10(10):1539-46.
• Arakawa H, Niimi H, Kurihara Y, NakajimaY, Webb WR. Expiratory High- Resolution CT: Diagnostic Value in Dif- fuse Lung Diseases. AJR 2000;175(6):1537-43.
• Lakadamyalı H, Alpar S, Lakadamyalı H, Ertürk H, Kurt B. Kronik Obstrüktif Akciğer Hastalığında Yüksek Rezolüs- yonlu Bilgisayarlı Tomografi Bulguları ile Solunum Fonk- siyon Testleri Arasındaki Korelasyon. Türk Toraks Dergisi 2006;7(1):17-22.
• Choi SJ, Choi BK, Kim HJ, Lee SH, Choi SH, Park SJ et al. Lateral decubitus HRCT: a simple technique to replace expiratory CT in children with air trapping. Pediatr Radiol 2002;32(3):179-82.
• Gurney JW, Jones KK, Robbins RA, Gossman GL, Nelson KJ, Daughton D et al. Regional distribution of emphysema correlation of high-resolution CT with pulmonary function tests in unselected smokers. Radiology 1992;183(2):457- 63.
• Kubo K, Eda S, Yamamoto H, Fujimoto K, Matsuzawa Y, Maruyama Y et al. Expiratory and inspiratory chest com- puted tomography and pulmonary function tests in cigarette smokers. Eur Respir J 1999;13(2):252-6.
• Wallace EJ, Chung F. General anesthesia in a patient with an enlarged saber sheath trachea. Anesthesiology 1998;88(2):527-9.
• Grene R. Saber sheath trachea: Relation to chronic obstruc- tive pulmonary disease. AJR 1978;130(3):441-5.
• Muro S, Nakano Y, Sakai H, Takubo Y, Oku Y, Chin K et al. Distored Trachea in Patients with Chronic Obstructive Pulmonary Disease. Reapiration 2000;67(6):638-44.