Airway narrowing in excised canine lungs measured by high-resolution computed tomography

1992 ◽  
Vol 73 (1) ◽  
pp. 307-316 ◽  
Author(s):  
A. E. McNamara ◽  
N. L. Muller ◽  
M. Okazawa ◽  
J. Arntorp ◽  
B. R. Wiggs ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Transpulmonary Pressure ◽  
Chronic Obstructive ◽  
Lumen Area ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Airway Narrowing ◽  
Computed Tomographic ◽  
Airway Dimensions

The exact site of airway narrowing in asthma and chronic obstructive pulmonary disease is unknown. High-resolution computed tomography (HRCT) is a sensitive noninvasive imaging technique that can be used to measure airway dimensions. After determining the optimal computed tomographic parameters using a phantom, we measured lobe volume and airway dimensions of isolated canine lung lobes at a transpulmonary pressure of 25 cmH2O. These measurements were repeated after deflation and administration of aerosolized saline and carbachol (256 mg/ml). Lobe volume decreased with all treatments. The maximal lobar volume change was 26% at 6 cmH2O after carbachol. Average airway lumen area decreased with all treatments. After carbachol, at transpulmonary pressures of 25, 15, 10, 8, and 6 cmH2O, lumen area decreased by 7.3 +/- 4.1, 62.0 +/- 4.9, 77.5 +/- 3.0, 31.9 +/- 9.0, and 95.2 +/- 1.0% (SE), respectively. When the airways were divided into four categories on the basis of initial lumen diameter (less than 2, 2–4, 4–6, and greater than 6 mm), the greatest decreases in luminal area after carbachol were seen in intermediate-sized airways (2–4 mm, 56 +/- 4%; 4-6 mm, 59 +/- 3%). HRCT can be used to make accurate measurements of airway dimensions and airway narrowing in excised lungs. HRCT may allow measurement of airway wall thickness and determination of the site of airway narrowing in asthma.

scholarly journals Phenotyping of Chronic Obstructive Pulmonary Disease Using the Modified Bhalla Scoring System for High-Resolution Computed Tomography

2013 ◽  
Vol 20 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Baykal Tulek ◽  
Ali Sami Kivrak ◽  
Seda Ozbek ◽  
Fikret Kanat ◽  
Mecit Suerdem
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Resolution ◽  
Pulmonary Disease ◽  
Scoring System ◽  
Morphological Changes ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease

BACKGROUND: Identifying different phenotypes of chronic obstructive pulmonary disease (COPD) is important for both therapeutic options and clinical outcome of the disease.OBJECTIVE: To characterize the phenotypes of COPD according to high-resolution computed tomography (HRCT) findings; and to correlate HRCT scores obtained using the modified Bhalla scoring system with clinical and physiological indicators of systemic inflammation.METHODS: The present study included 80 consecutive patients with stable COPD. HRCT scans were evaluated by two independent radiologists according to the modified Bhalla scoring system.RESULTS: Fifty-four patients exhibited morphological changes on HRCT examination while 26 had no pathological findings. Patients with HRCT findings had lower spirometric measurements and higher levels of inflammation, and reported more exacerbations in the previous year compared with patients with no findings on HRCT. Patients with morphological changes were classified into one of three groups according to their HRCT phenotype(s): emphysema (E) only, E + bronchiectasis (B)/peribronchial thickening (PBT) or B/PBT only. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, C-reactive protein (CRP) levels and the number of exacerbations among the groups were significantly different. Pairwise comparisons between the E only and E+B/PBT groups showed significantly lower FVC, FEV1and FEV1/FVC values, and higher CRP levels and number of exacerbations compared with the B/PBT group. No significant differences were found between the E+B/PBT and the B/PBT groups. An inverse correlation was found between the total HRCT score and FVC, FEV1and FEV1/FVC; the correlation was positive with CRP level, erythrocyte sedimentation rate and number of exacerbations.CONCLUSION: The present study exposed the intimate relationship between phenotype(s) characterized by HRCT and scoring for morphological abnormalities; and clinical and functional parameters and inflammatory markers. The inclusion of HRCT among routine examinations for COPD may provide significant benefits both in the management and prognosis of COPD patients.

S162 – Chronic Aspiration after Supracricoid Partial Laryngectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P130-P131
Author(s):  
Andrea Gallo ◽  
Giovanni Ruoppolo ◽  
Marco Di Mario ◽  
Calcagno Paola ◽  
Manciocco Valentina ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Case Series ◽  
Control Group ◽  
Chronic Obstructive ◽  
Partial Laryngectomy ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Supracricoid Partial Laryngectomy ◽  
Control Evaluation

Objectives The aim of this study is to evaluate the long-term swallowing status and the high resolution computed tomography (HRCT) pulmonary findings of chronic aspiration in patients who have undergone supracricoid partial laryngectomy (SCPL), to demonstrate that SCPL causes a mild and well-tolerated degree of chronic aspiration, allowing the patient to avoid a nothing-by-mouth status. Methods Retrospective medical record review. Cohort study. Case series. The follow-up period ranged from 3 to 13 years. 116 patients treated with SCPL were analyzed. The patients included in the study were NED, were followed for more than 3 years, were without tracheal cannula or nasogastric tube, and able to feed orally. A group of 20 patients with chronic obstructive pulmonary disease and normal deglutition was used as a control. Evaluation of postoperative swallowing disorders included a careful observation of the patients by the physician, fiberoptic endoscopic evaluation of swallowing (FEES), and videofluoroscopy (VFS). Clinical grading of postoperative aspiration was assessed according to the Leipzig and Pearson scale. The radiological manifestations of chronic aspiration were recorded at high resolution computed tomography (HRCT). Results A higher incidence of pulmonary consolidation was found in the patients affected by postoperative chronic aspiration, compared to the control group (p<0.001). No significant differences were noted between the control group and the dysphagic group regarding the remaining radiological findings. Conclusions SCPL causes a mild and well-tolerated degree of chronic aspiration, determining low functional impairment and allows the patient a good quality of life.

scholarly journals High resolution computed tomography in chronic obstructive pulmonary disease

2018 ◽  
Vol 5 (5) ◽  
pp. 1222
Author(s):  
Pragati Rao D. ◽  
Aruna Talatam ◽  
Chakradhar B. ◽  
Bhargavi K. ◽  
Bhagyaraj A.
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Resolution ◽  
Pulmonary Disease ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
X Rays ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterised by persistent respiratory symptoms and airflow limitation with varied presentations (bronchitis and emphysema). High resolution computed tomography (HRCT) plays an important role in identifying the various morphologies thereby reducing morbidity and mortality. The aim of the present study was to evaluate the role of high resolution computed tomography in COPD patients. The Objectives of the present study was to differentiate emphysema predominant, airway predominant and mixed phenotypes and to identify other disease processes and complications.Methods: 50 COPD patients attending Respiratory medicine Department, NRI general hospital were advised for chest x-rays and pulmonary function tests. All the patients selected were smokers with no other co-morbid illnesses. Those patients whose chest x-rays showed no other changes except for COPD changes were selected for HRCT chest.Results: Out of 50 COPD patients emphysema predominance was present in 28 patients (56%), bronchitis predominance in 19 patients (38%) and 3(6%) patients had mixed pattern. In emphysema centriacinar pattern was commonly seen (42.9%), paraseptal in 35.71%, panacinar in 3.57% and bullae in 17.8% cases. All the patients were chronic smokers with pack years >20. All are males with average age above 45 years. Emphysema was common in elderly patients with age above 50 years. Chronic bronchitis is predominantly seen in the age group 40-50 years. Additional diagnoses like bronchiectasis, mass, ILD were identified in 28% cases.Conclusions: HRCT plays a significant role in COPD patients in differentiating phenotypes which have different modes of therapy. Other subtle changes in lungs which cannot be identified on chest x ray are discernible on HRCT. Early identification of complications reduces morbidity and mortality.

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