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Kronik obstrüktif akciğer hastalığının radyolojik değerlendirilmesinde yeni yaklaşımlar

Yıl 2010, Cilt: 17 Sayı: 4, 29 - 37, 30.12.2010

Öz

Kronik obstrüktif akciðer hastalýðý (KOAH), amfizem veya havayolunun daralmasý, veya her ikisinin birlikteliði ile nitelenen havayolu obstrüksiyonudur. Akciðer grafisi, atak ile gelen KOAHlý hastayý deðerlendirmede önemli bir yöntemdir. Buna karþýn taný koydurucu olmak yerine daha çok tanýyý destekleyici bir yöntem olarak kabul edilmektedir. Bu yüzden KOAHýn deðerlendirilmesi ve erken tanýsý için yeni yöntemlere ihtiyaç duyulmaktadýr. Büyük ve küçük havayollarý çaplarýnýn bilgisayarlý tomografi ile ölçümü KOAHlý hastalarda ve saðlýklý sigara içicilerde akciðer fonksiyonlarýný deðerlendirmede yararlý bir yöntemdir. Yakýn zamanda, yüksek çözünürlü bilgisayarlý tomografi (YÇBT) havayolu çaplarýnýn ölçümü için kullanýlmýþtýr. KOAHýn morfolojik tiplerine sýnýflandýrýlmasýnda YÇBTnin kullanýlmasý bronkodilatör veya inhale kortikosteroid tedavisine cevap verecek hastalarýn açýða çýkarýlmasýnda faydalý olabilir. Gelecekte KOAHýn patogenezinin, doðasýnýn ve fenotiplerinin anlaþýlmasýnda görüntüleme yöntemleri çok daha fazla katkýda bulunacaktýr.

Kaynakça

  • Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA,
  • Calverley P, et al. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176(6):532- 55.
  • American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1995;152(5 Pt 2):S77-121.
  • Yýldýrým N. KOAH. Türk Toraks Derneði 1. Mesleki Geliþim Kursu Kitapçýðý 2004;39-42.
  • Saryal SB. Kronik obstrüktif akciðer hastalýðýnda taný yöntemleri. In:Kronik Obstrüktif Akciðer Hastalýðý. Umut S. Ertürk E. (eds). Toraks Derneði Yayýnlarý Sayý:2, Ýstanbul, Turgut Yayýncýlýk ve Tiç. A.Þ. 2000;63- 82.
  • Lakadamyalý H, Alpar S, Lakadamyalý H, Ertürk H, Kurt B. Kronik obstrüktif Akciðer hastalýðýnda yüksek rezolüsyonlu bilgisayarlý tomografi bulgularý ile solunum fonksiyon testleri arasýndaki korelasyon Toraks Dergisi 2006; 7(1):17-22.
  • Reid L, Millard FJC. Correlation between radiological diagnosis and structural lung changes in emphysema. Clin Radiol 1964; 15(4):307–11.
  • Nicklaus TM, Stowell DW, Christiansen WR, Renzetti AD, Jr. The accuracy of the roentgenologic diagnosis of chronic pulmonary emphysema. Am Rev Respir Dis 1966; 93(6):889–99.
  • Reich SB, Weinshelbaum A, Yee J. Correlation of radiographic measurements and pulmonary function tests in chronic obstructive pulmonary disease. Am J Roentgenol 1985; 144(4):695-9.
  • Greene R. “Saber–Sheath” trachea: Relation to chronic obstructive pulmonary disease. Am J Roentgenol 1978; 130(3):441–5.
  • Fraser RG, Fraser RS, Renner JW, Bernard C, Fitzgerald PJ. The roentgenologic diagnosis of chronic bronchitis: A reassessment with emphasis on parahilar bronchi seen end-on. Radiology 1976; 120(1):1–9.
  • Matthay RA, Schwarz MI, Ellis JH, Jr. Steele PP, Siebert PE, Durrance JR, et al. Pulmonary artery hypertension in chronic obstructive pulmonary disease: determination by chest radiography. Invest Radiol 1981; 16(2):95–100.
  • Erdinç E, Erk M, Kocabaþ A, Mirici A, Süerdem M, Tatlýcýoðlu T, ve ark. KOAH çalýþma grubu. Toraks Derneði Kronik Obstrüktif Akciðer Hastalýðý Taný ve Tedavi Rehberi. Toraks Dergisi 2000; 1(Ek 2):1-25.
  • Bayramoðlu S, Çetinkaya E, Taþyürek O, Unat A, Özcan M, Kaya L. Akciðer amfizeminin tanýsýnda inspiratuar ve ekspiratuar BT bulgularý: kalitatif ve kantitatif deðerlendirme. Tanýsal ve Giriþimsel Radyoloji 2000; 6(3):309-13.
  • Bergin C, Muller N, Nichols DM, Lillington G, Hogg JC, Mullen B, et al. The diagnosis of emphysema. A computed tomographic pathologic correlation. Am Rev Respir Dis 1986; 133(4):541–6.
  • Hruban RH, Meziane MA, Zerhouni EA, Khouri NF, Fishman EK, Wheeler PS, et al. High resolution computed tomography of inflation-fxed lungs. Pathologic radiologic correlation of centrilobular emphysema. Am Rev Respir Dis 1987; 136(4):935–40.
  • Kuwano K, Matsuba K, Ikeda T, Murakami J, Araki A, Nishitani H, et al. The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores. Am Rev Respir Dis1990; 141(1):169–78.
  • Sakai F, Gamsu G, Im J, Ray CS. Pulmonary function abnormalities in patients with CT- determined emphysema. J Comput Assist Tomogr 1987; 11(6):963- 8.
  • Morgan MDL. Detection and quantification of pulmonary emphysema by computed tomography. A window of opportunity. Thorax 1992; 47(12):1001-4.
  • Shaker SB, Dirksen A, Bach KS, Mortensen J. Imaging in chroniic obstructive pulmonary disease. COPD: Journal of Chronic Obstructive Pulmonary Disease 2007; 4(2):143-61.
  • Remy-Jardin M, Remy J, Boulenguez C, Sobaszek A, Edme JL, Furon D. Morphologic effects of cigarette smoking on airways and pulmonary parenchyma in healthy adult volunteers: CT evaluation and correlation with pulmonary function tests. Radiology 1993; 186(1):107–15.
  • Nakano Y, Muro S, Sakai H, Hirai T, Chin K, Tsukino M, et al. Computed tomographic measurements of airway dimensions and emphysema in smokers. Correlation with lung function. Am J Respir Crit Care Med. 2000;162(3 Pt 1):1102-8.
  • Orlandi I, Moroni C, Camiciottoli G, Bartolucci M, Pistolesi M, Villari N, et al. Chronic obstructive pulmonary disease: thin-section CT measurement of airway wall thickness and lung attenuation. Radiology 2005; 234(2):604–10.
  • Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 2004; 350(26):2645–53.
  • Hasegawa M, Nasuhara Y, Onodera Y, Makita H, Nagai K, Fuke S, et al. Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006; 173(12):1309–15.
  • Bayramoðlý S, Çetinkaya E, Taþyürek O, Unat A, Özcan M, Kaya L. Akciðer amfizeminin tanýsýnda inspiratuar ve ekspiratuar BT bulgularý: kalitatif ve kantitatif deðerlendirme. Tanýsal ve Giriþimsel Radyoloji 2000; 6(3):309-13.
  • Stern EJ, Webb WR, Warnock ML, Salmon CJ. Bronchopulmonary sequestration: dynamic, ultrafast, high-resolution CT evidence of air trapping. Am J Roentgenol 1991; 157(5): 947-9.
  • Webb WR, Stern EJ, Kanth N, Gamsu G. Dynamic pulmonary CT: findings in healthy adult men. Radiology 1993;186(1):117-24.
  • Stern EJ, Webb WR, Gamsu G. Dynamic quantitative computed tomography. A predictor of pulmonary function in obstructive lung diseases. Invest Radiol 1994;29(5):564-9.
  • Arakawa H, Webb WR. Air trapping on expiratory high-resolution CT scans in the absence of inspiratory scan abnormalities: correlation with pulmonary function tests and differential diagnosis. Am J Roentgenol 1998; 170(5):1349-53.
  • Arakawa H, Webb WR, McCowin M, Katsou G, Lee KN, Seitz RF. In homogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans. Radiology 1998;206(1): 89-94.
  • Mavili E, Büyükoðlan H, Çomu NB, Güleç M. Expiratory CT. Correlation with Pulmonary Function Tests and Value for Discriminating Lung Diseases Eur J Gen Med 2010;7(1):56-62.
  • Lee KW, Chung SY, Yang I, Lee Y, Ko YE, Park MJ. Correlation of aging and smoking with air trapping at thin section CT of the lung in asymptomatic subjects. Radiology 2000; 214(3):831-6.
  • Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS, the GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) workshop summary. Am J Respir Crit Care Med 2001; 163(5):1256–76.
  • National Emphysema Treatment Trial Research Group. Patients at high risk of death after lung-volume- reduction surgery. N Engl J Med 2001; 345(15):1075–83
  • de Torres JP, Bastarrika G, Wisnivesky JP, Alcaide AB, Campo A, Seijo LM, et al. Assessing the Relationship Between Lung Cancer Risk and Emphysema Detected on Low-Dose CT of the Chest Chest 2007; 132(6);1932-8
  • Kohlhaufl M, Brand P, Rock C, Radons T, Scheuch G, Meyer T, et al. Noninvasive diagnosis of emphysema. Am J Respir Crit Care Med 1999; 160(3):913-8.
  • Irion KL, Hochhegger B, Marchiori E, Porto NS, Baldisserotto SV, Santana PR. Chest X-ray and computed tomography in the evaluation of pulmonary emphysema. J Bras Pneumol 2007; 33(6):720-32.
  • Celli BR. Chronic obstructive pulmonary disease phenotypes and their clinical relevance. Proc Am Thorac Soc 2006; 3(1):461–6.
  • Coxson HO, Rogers RM. New concepts in the radiological assessment of COPD. Semin Respir Crit Care Med. 2005; 26(2):211-20.
  • Haraguchi M, Shimura S, Shirato K. Morphometric analysis of bronchial cartilage in chronic obstructive pulmonary disease and bronchial asthma. Am J Respir Crit Care Med 1999; 159(3):1005-13.
  • Tiddens HA, Pare PD, Hogg JC, Hop WC, Lambert R, de Johnsgate JC. Cartilaginous airway dimensions and airflow obstruction in human lungs. Am J Respir Crit Care Med; 1995; 152(1):260-6.
  • Deveci F, Murat A, Turgut T, Altuntaþ E, Muz MH. Airway wall thickness in patients with COPD and healthy current smokers and healthy non-smokers: Assessment with high resolution computed tomographic scanning. Respiration 2004; 71(6):602-10.
  • Heremans A, Verschakelen JA, Vanfraeyenhoven L, Demedts M. Measurement of lung density by means of quantitative CT scaning. Chest 1992; 10(3):805-11.
  • Eric J. Stern, Mark S. Frank. CT of the lung in patients with pulmonary emphysema: diagnosis, quantification, and correlation with pathologic and physiologic findings. American Journal of Roentgenology 1994;162(4):791-8.
  • Atasoy P.KOAH’ta Patoloji. TTD Toraks Cerrahisi Bülteni 2010; 1(2):119-23.
  • Chung KF. The role of airway smooth muscle in the pathogenesis of airway wall remodelling in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005; 2 (4): 347-54.
  • Husein AN, Kumar V. The Lung.In Kumar AV, Abbas AK, Fausto N ed. Robbins and Cotran Pathologic Basis of Disease, 7th ed. Elsevier Saunders; 2005; 711-72.
  • Wright JL, Churg A. Advances in the pathology of COPD. Histopathology 2006; 49(1): 1-9.
  • http://www.radiologyassistant.nl/en/42d94cd0c326b.
  • Koç Z, Bayram M, Ekinci E. Semptomatik amfizem olgularýnda yüksek rezolüsyonlu BT. Tanýsal ve Giriþimsel Radyoloji 1994;1:132-37.
  • Spouge D, Mayo JR, Cardoso W, Muller NL. Panaciner emphysema: CT and pathologic findings. J Comput Assist Tomogr 1993; 17(5):710-3.
  • Tylén U, Boijsen M, Ekberg-Jansson A, Bake B, Lofdahl CG. Emphysematous lesions and lung function in healthy smokers 60 years of age. Respir Med 2000; 94(1):38-43.
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The new approaches in radiological assessments of chronic obstructive pulmonary disease

Yıl 2010, Cilt: 17 Sayı: 4, 29 - 37, 30.12.2010

Öz

Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction caused by emphysema or airway narrowing, or both. Chest radiography is an important tool in assessing patients with COPD presenting with worsening symptoms. Even so, it is accepted as a supportive method instead of being diagnostic. Thus, new approaches are required to diagnose and decide COPD early. The computed tomography measurements of large and small airway dimensions are useful for evaluating lung functions in patients with COPD and healthy current smokers. Recently, airway dimensions have been measured using high resolution computed tomography (HRCT). Classification of COPD into morphological phenotypes using
HRCT may help in identifying those patients who will respond to selective therapy (bronchodilators or inhaled corticosteroid treatment). In the future, our understanding of the pathogenesis, natural history and phenotypes of COPD will be immensely promoted by imaging.

Kaynakça

  • Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA,
  • Calverley P, et al. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176(6):532- 55.
  • American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1995;152(5 Pt 2):S77-121.
  • Yýldýrým N. KOAH. Türk Toraks Derneði 1. Mesleki Geliþim Kursu Kitapçýðý 2004;39-42.
  • Saryal SB. Kronik obstrüktif akciðer hastalýðýnda taný yöntemleri. In:Kronik Obstrüktif Akciðer Hastalýðý. Umut S. Ertürk E. (eds). Toraks Derneði Yayýnlarý Sayý:2, Ýstanbul, Turgut Yayýncýlýk ve Tiç. A.Þ. 2000;63- 82.
  • Lakadamyalý H, Alpar S, Lakadamyalý H, Ertürk H, Kurt B. Kronik obstrüktif Akciðer hastalýðýnda yüksek rezolüsyonlu bilgisayarlý tomografi bulgularý ile solunum fonksiyon testleri arasýndaki korelasyon Toraks Dergisi 2006; 7(1):17-22.
  • Reid L, Millard FJC. Correlation between radiological diagnosis and structural lung changes in emphysema. Clin Radiol 1964; 15(4):307–11.
  • Nicklaus TM, Stowell DW, Christiansen WR, Renzetti AD, Jr. The accuracy of the roentgenologic diagnosis of chronic pulmonary emphysema. Am Rev Respir Dis 1966; 93(6):889–99.
  • Reich SB, Weinshelbaum A, Yee J. Correlation of radiographic measurements and pulmonary function tests in chronic obstructive pulmonary disease. Am J Roentgenol 1985; 144(4):695-9.
  • Greene R. “Saber–Sheath” trachea: Relation to chronic obstructive pulmonary disease. Am J Roentgenol 1978; 130(3):441–5.
  • Fraser RG, Fraser RS, Renner JW, Bernard C, Fitzgerald PJ. The roentgenologic diagnosis of chronic bronchitis: A reassessment with emphasis on parahilar bronchi seen end-on. Radiology 1976; 120(1):1–9.
  • Matthay RA, Schwarz MI, Ellis JH, Jr. Steele PP, Siebert PE, Durrance JR, et al. Pulmonary artery hypertension in chronic obstructive pulmonary disease: determination by chest radiography. Invest Radiol 1981; 16(2):95–100.
  • Erdinç E, Erk M, Kocabaþ A, Mirici A, Süerdem M, Tatlýcýoðlu T, ve ark. KOAH çalýþma grubu. Toraks Derneði Kronik Obstrüktif Akciðer Hastalýðý Taný ve Tedavi Rehberi. Toraks Dergisi 2000; 1(Ek 2):1-25.
  • Bayramoðlu S, Çetinkaya E, Taþyürek O, Unat A, Özcan M, Kaya L. Akciðer amfizeminin tanýsýnda inspiratuar ve ekspiratuar BT bulgularý: kalitatif ve kantitatif deðerlendirme. Tanýsal ve Giriþimsel Radyoloji 2000; 6(3):309-13.
  • Bergin C, Muller N, Nichols DM, Lillington G, Hogg JC, Mullen B, et al. The diagnosis of emphysema. A computed tomographic pathologic correlation. Am Rev Respir Dis 1986; 133(4):541–6.
  • Hruban RH, Meziane MA, Zerhouni EA, Khouri NF, Fishman EK, Wheeler PS, et al. High resolution computed tomography of inflation-fxed lungs. Pathologic radiologic correlation of centrilobular emphysema. Am Rev Respir Dis 1987; 136(4):935–40.
  • Kuwano K, Matsuba K, Ikeda T, Murakami J, Araki A, Nishitani H, et al. The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores. Am Rev Respir Dis1990; 141(1):169–78.
  • Sakai F, Gamsu G, Im J, Ray CS. Pulmonary function abnormalities in patients with CT- determined emphysema. J Comput Assist Tomogr 1987; 11(6):963- 8.
  • Morgan MDL. Detection and quantification of pulmonary emphysema by computed tomography. A window of opportunity. Thorax 1992; 47(12):1001-4.
  • Shaker SB, Dirksen A, Bach KS, Mortensen J. Imaging in chroniic obstructive pulmonary disease. COPD: Journal of Chronic Obstructive Pulmonary Disease 2007; 4(2):143-61.
  • Remy-Jardin M, Remy J, Boulenguez C, Sobaszek A, Edme JL, Furon D. Morphologic effects of cigarette smoking on airways and pulmonary parenchyma in healthy adult volunteers: CT evaluation and correlation with pulmonary function tests. Radiology 1993; 186(1):107–15.
  • Nakano Y, Muro S, Sakai H, Hirai T, Chin K, Tsukino M, et al. Computed tomographic measurements of airway dimensions and emphysema in smokers. Correlation with lung function. Am J Respir Crit Care Med. 2000;162(3 Pt 1):1102-8.
  • Orlandi I, Moroni C, Camiciottoli G, Bartolucci M, Pistolesi M, Villari N, et al. Chronic obstructive pulmonary disease: thin-section CT measurement of airway wall thickness and lung attenuation. Radiology 2005; 234(2):604–10.
  • Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, et al. The nature of small-airway obstruction in chronic obstructive pulmonary disease. N Engl J Med 2004; 350(26):2645–53.
  • Hasegawa M, Nasuhara Y, Onodera Y, Makita H, Nagai K, Fuke S, et al. Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006; 173(12):1309–15.
  • Bayramoðlý S, Çetinkaya E, Taþyürek O, Unat A, Özcan M, Kaya L. Akciðer amfizeminin tanýsýnda inspiratuar ve ekspiratuar BT bulgularý: kalitatif ve kantitatif deðerlendirme. Tanýsal ve Giriþimsel Radyoloji 2000; 6(3):309-13.
  • Stern EJ, Webb WR, Warnock ML, Salmon CJ. Bronchopulmonary sequestration: dynamic, ultrafast, high-resolution CT evidence of air trapping. Am J Roentgenol 1991; 157(5): 947-9.
  • Webb WR, Stern EJ, Kanth N, Gamsu G. Dynamic pulmonary CT: findings in healthy adult men. Radiology 1993;186(1):117-24.
  • Stern EJ, Webb WR, Gamsu G. Dynamic quantitative computed tomography. A predictor of pulmonary function in obstructive lung diseases. Invest Radiol 1994;29(5):564-9.
  • Arakawa H, Webb WR. Air trapping on expiratory high-resolution CT scans in the absence of inspiratory scan abnormalities: correlation with pulmonary function tests and differential diagnosis. Am J Roentgenol 1998; 170(5):1349-53.
  • Arakawa H, Webb WR, McCowin M, Katsou G, Lee KN, Seitz RF. In homogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans. Radiology 1998;206(1): 89-94.
  • Mavili E, Büyükoðlan H, Çomu NB, Güleç M. Expiratory CT. Correlation with Pulmonary Function Tests and Value for Discriminating Lung Diseases Eur J Gen Med 2010;7(1):56-62.
  • Lee KW, Chung SY, Yang I, Lee Y, Ko YE, Park MJ. Correlation of aging and smoking with air trapping at thin section CT of the lung in asymptomatic subjects. Radiology 2000; 214(3):831-6.
  • Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS, the GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) workshop summary. Am J Respir Crit Care Med 2001; 163(5):1256–76.
  • National Emphysema Treatment Trial Research Group. Patients at high risk of death after lung-volume- reduction surgery. N Engl J Med 2001; 345(15):1075–83
  • de Torres JP, Bastarrika G, Wisnivesky JP, Alcaide AB, Campo A, Seijo LM, et al. Assessing the Relationship Between Lung Cancer Risk and Emphysema Detected on Low-Dose CT of the Chest Chest 2007; 132(6);1932-8
  • Kohlhaufl M, Brand P, Rock C, Radons T, Scheuch G, Meyer T, et al. Noninvasive diagnosis of emphysema. Am J Respir Crit Care Med 1999; 160(3):913-8.
  • Irion KL, Hochhegger B, Marchiori E, Porto NS, Baldisserotto SV, Santana PR. Chest X-ray and computed tomography in the evaluation of pulmonary emphysema. J Bras Pneumol 2007; 33(6):720-32.
  • Celli BR. Chronic obstructive pulmonary disease phenotypes and their clinical relevance. Proc Am Thorac Soc 2006; 3(1):461–6.
  • Coxson HO, Rogers RM. New concepts in the radiological assessment of COPD. Semin Respir Crit Care Med. 2005; 26(2):211-20.
  • Haraguchi M, Shimura S, Shirato K. Morphometric analysis of bronchial cartilage in chronic obstructive pulmonary disease and bronchial asthma. Am J Respir Crit Care Med 1999; 159(3):1005-13.
  • Tiddens HA, Pare PD, Hogg JC, Hop WC, Lambert R, de Johnsgate JC. Cartilaginous airway dimensions and airflow obstruction in human lungs. Am J Respir Crit Care Med; 1995; 152(1):260-6.
  • Deveci F, Murat A, Turgut T, Altuntaþ E, Muz MH. Airway wall thickness in patients with COPD and healthy current smokers and healthy non-smokers: Assessment with high resolution computed tomographic scanning. Respiration 2004; 71(6):602-10.
  • Heremans A, Verschakelen JA, Vanfraeyenhoven L, Demedts M. Measurement of lung density by means of quantitative CT scaning. Chest 1992; 10(3):805-11.
  • Eric J. Stern, Mark S. Frank. CT of the lung in patients with pulmonary emphysema: diagnosis, quantification, and correlation with pathologic and physiologic findings. American Journal of Roentgenology 1994;162(4):791-8.
  • Atasoy P.KOAH’ta Patoloji. TTD Toraks Cerrahisi Bülteni 2010; 1(2):119-23.
  • Chung KF. The role of airway smooth muscle in the pathogenesis of airway wall remodelling in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005; 2 (4): 347-54.
  • Husein AN, Kumar V. The Lung.In Kumar AV, Abbas AK, Fausto N ed. Robbins and Cotran Pathologic Basis of Disease, 7th ed. Elsevier Saunders; 2005; 711-72.
  • Wright JL, Churg A. Advances in the pathology of COPD. Histopathology 2006; 49(1): 1-9.
  • http://www.radiologyassistant.nl/en/42d94cd0c326b.
  • Koç Z, Bayram M, Ekinci E. Semptomatik amfizem olgularýnda yüksek rezolüsyonlu BT. Tanýsal ve Giriþimsel Radyoloji 1994;1:132-37.
  • Spouge D, Mayo JR, Cardoso W, Muller NL. Panaciner emphysema: CT and pathologic findings. J Comput Assist Tomogr 1993; 17(5):710-3.
  • Tylén U, Boijsen M, Ekberg-Jansson A, Bake B, Lofdahl CG. Emphysematous lesions and lung function in healthy smokers 60 years of age. Respir Med 2000; 94(1):38-43.
  • http://www.mevis-research.de/~hhj/Lunge/xSammlCOPDFr.html
  • Dowson LJ, Guest PJ, Hill SL, Holder RL, Stockley RA. High-resolution computed tomography scanning in alpha1-antitrypsin deficiency: relationship to lung function and health status. Eur Respir J 2001;17(6):1097-104.
  • Takahashi M, Fukuoka J, Nitta N, Takazakura R, Nagatani Y, Murakami Y, et al. Imaging of pulmonary emphysema: a pictorial review. Int J Chron Obstruct Pulmon Dis 2008;3(2):193-204.
  • Thurlbeck WM, Muller NL. Emphysema: definition, imaging, and quantification. Am J Roentgenol 1994;163(5):1017–25.
  • Hogg JC. Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. Lancet 2004; 364(9435):709–21.
  • Baldi S, Miniati M, Bellina CR, Battolla L, Catapano G, Begliomini E, et al. Relationship between extent of pulmonary emphysema by high-resolution computed tomography and lung elastic recoil in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001; 164(4):585–9.
  • Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA,et al.The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004;350 (10):1005–12.
  • Welte T. Acute Exacerbation of Chronic Obstructive Pulmonary Disease: More a Functional than an Inflammatory Problem? Am J Respir Crit Care Med. 2008;177(2):130-1.
  • Boschetto P, Quintavalle S, Zeni E, Leprotti S, Potena A, Ballerin L, et al. Thorax. 2006;61(12):1037-42.
  • Gupta PR, Yadav R, Verma M, Agarwal D, Kumar M. Correlation between high-resolution computed tomography features and patients' characteristics in chronic obstructive pulmonary disease. Annals of Thoracic Medicine 2008;3(3):87-93.
  • Torres I, Allona M, Martínez M, Lores V, Rojo B, García-Río F. Severity-related differences in lung attenuation in men with COPD. Arch Bronconeumol 2010 Feb;46(2):56-63.
  • Cerveri I, Dore R, Corsico A, Zoia MC, Pellegrino R, Brusasco V, et al. Assessment of emphysema in COPD: afunctional and radiologic study. Chest 2004;125(5):1714–8.
  • Fujimoto K, Kitaguchi Y, Kubo K, et al. Clinical analysis of chronic obstructive pulmonary disease phenotypes classified using high-resolution computed tomography. Respirology 2006;11(6):731–40
  • Gu SY, Li QY, Wan HY, Ren L, Sun XW, Deng WW. Characteristics of chronic obstructive pulmonary disease phenotypes based on high-resolution CT and the relationship with interleukin-6. Zhonghua Jie He He Hu Xi Za Zhi. 2010;33(4):256-60.
  • Kitaguchi Y, Fujimoto K, Kubo K, Honda T. Characteristics of COPD phenotypes classified according to the findings of HRCT.Respir Med. 2006;100(10):1742-52.
  • Zompatori M, Sverzellati N, Poletti V, Bnà C, Ormitti F, Spaggiari E, et al. High-resolution CT in diagnosis of diffuse infiltrative lung disease. Semin Ultrasound CT MR 2005; 26(5): 332-47.
  • Gotway MB, Reddy GP, Webb WR, Elicker BM, Leung JW. High-resolution CT of the lung: Patterns of disease and differential diagnoses. Radiol Clin North Am 2005; 43(5): 513-42.
  • Müller NL, Staples CA, Miller RR, About RT. ‘Density Mask’ An objective method to quantitative emphysema using computed tomography. Chest 1988; 94(4): 782- 7.
  • Arakawa H, Webb RW. Expiratory high-resolution CT scan. Radiol Clin North Am 1998; 36(1):189-209.
  • Knudson RJ, Standen JR, Kaltenborn WT, Knudson DE, Rehm K. Expiratory computed tomography for assessment of suspected pulmonary emphysema. Chest 1991; 99(6):1357-66.
Toplam 73 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Diş Hekimliği
Bölüm Derlemeler
Yazarlar

Önder Öztürk

Mert Köroğlu Bu kişi benim

Duygu Zorlu Karayiğit Bu kişi benim

Mehmet Gündüz Bu kişi benim

Yayımlanma Tarihi 30 Aralık 2010
Gönderilme Tarihi 31 Ocak 2011
Yayımlandığı Sayı Yıl 2010 Cilt: 17 Sayı: 4

Kaynak Göster

Vancouver Öztürk Ö, Köroğlu M, Zorlu Karayiğit D, Gündüz M. Kronik obstrüktif akciğer hastalığının radyolojik değerlendirilmesinde yeni yaklaşımlar. SDÜ Tıp Fak Derg. 2010;17(4):29-37.

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