Computed tomography airway tree tortuosity features predict functional small airway disease in chronic obstructive pulmonary disease

Over 1 000 000 Canadians are diagnosed with Chronic Obstructive Pulmonary Disease (COPD) and by 2020 the disease will be the third deadliest on Earth. Despite high prevalence, diagnosis of COPD occurs late in the disease course, after a large portion of the small airways are destroyed. Current methods to quantify small airway disease (SAD) using the Disease Probability Measure (DPM) approach requires CT images acquired at full inspiration and full expiration, and therefore there are technical challenges and dose concerns Computed Tomography (CT) imaging using only a single full inspiration CT image can be used segment the central airway tree and generate quantitative morphometric measurements.

Computed tomography airway tree tortuosity features predict functional small airway disease in chronic obstructive pulmonary disease

Over 1 000 000 Canadians are diagnosed with Chronic Obstructive Pulmonary Disease (COPD) and by 2020 the disease will be the third deadliest on Earth. Despite high prevalence, diagnosis of COPD occurs late in the disease course, after a large portion of the small airways are destroyed. Current methods to quantify small airway disease (SAD) using the Disease Probability Measure (DPM) approach requires CT images acquired at full inspiration and full expiration, and therefore there are technical challenges and dose concerns Computed Tomography (CT) imaging using only a single full inspiration CT image can be used segment the central airway tree and generate quantitative morphometric measurements.

Fast Phase-Contrast Cine MRI for Assessing Intracranial Hemodynamics and Cerebrospinal Fluid Dynamics

We propose fast phase-contrast cine magnetic resonance imaging (PC-cine MRI) to allow breath-hold acquisition, and we compared intracranial hemo- and hydrodynamic parameters obtained during breath holding between full inspiration and end expiration. On a 3.0 T MRI, using electrocardiogram (ECG)-synchronized fast PC-cine MRI with parallel imaging, rectangular field of view, and segmented k-space, we obtained velocity-mapped phase images at the mid-C2 level with different velocity encoding for transcranial blood flow and cerebrospinal-fluid (CSF) flow. Next, we calculated the peak-to-peak amplitudes of cerebral blood flow (ΔCBF), cerebral venous outflow, intracranial volume change, CSF pressure gradient (ΔPG), and intracranial compliance index. These parameters were compared between the proposed and conventional methods. Moreover, we compared these parameters between different utilized breath-hold maneuvers (inspiration, expiration, and free breathing). All parameters derived from the fast PC method agreed with those from the conventional method. The ΔPG was significantly higher during full inspiration breath holding than at the end of expiration and during free breathing. The proposed fast PC-cine MRI reduced scan time (within 30 s) with good agreement with conventional methods. The use of this method also makes it possible to assess the effects of respiration on intracranial hemo- and hydrodynamics.

Straight Back Syndrome

• On examination or on lateral CXR, sternum is not depressed • Measure chest wall expansion (with a tape measure) • Note vertical anterior ribs and straight left heart border • Difference between “senile emphysema” and rigid spine ∘ In “senile emphysema,” chest wall is fixed in near-full inspiration...

Peak flow

Peak flow 332 Peak flow is defined as the greatest expiratory flow achieved from a maximally forced expiratory effort when starting from a position of full inspiration. • Measurement should be performed as best of three with standardized meter (EU scale). There is no need to return the measuring plunger to zero following each attempt....

Threshold of airway response to inhaled methacholine in healthy men and women

Threshold of airway response to inhaled methacholine was determined using maximum expiratory partial flow-volume curves in 21 men and 36 women with similar age distribution, all of them healthy nonsmokers. Mean threshold was on average 1.3 doubling dose lower in women than men. There were no sex differences in the increase of maximum expiratory flows after a full inspiration when the airways were constricted by methacholine.