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Respir Care. 2018 Apr;63(4):430-440. doi: 10.4187/respcare.05815. Epub 2017 Dec 5.

The Role of Multidetector Computed Tomography and the Forced Oscillation Technique in Assessing Lung Damage in Adults With Cystic Fibrosis.

Author information

1
Postgraduate Program in Clinical and Experimental Physiopathology (FISCLINEX), School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
2
Cystic Fibrosis Centre, Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, Brazil. agnaldolopes.uerj@gmail.com.
3
Rehabilitation Sciences Post-Graduation Program, Augusto Motta University Center, Rio de Janeiro, Brazil.
4
Postgraduate Programme in Medical Sciences, School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
5
Laboratory of Respiration Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
6
Laboratory of Pulmonary Engineering, Biomedical Engineering Program, Alberto Luiz Coimbra Institute of Post-Graduation and Research in Engineering, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
7
Cystic Fibrosis Centre, Piquet Carneiro Polyclinic, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
8
Department of Radiology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
9
Biomedical Instrumentation Laboratory, Institute of Biology Roberto Alcantara Gomes and Laboratory of Clinical and Experimental Research in Vascular Biology (BioVasc), State University of Rio de Janeiro, Rio de Janeiro, Brazil.

Abstract

BACKGROUND:

With increased survival rates and the consequent emergence of an adult population with cystic fibrosis (CF), developing novel tools for periodic evaluations of these patients has become a new challenge. Thus, we sought to determine the contribution of lung-volume quantification using multidetector computed tomography (CT) in adults with CF and to investigate the association between structural changes and functional abnormalities.

METHODS:

This was a cross-sectional study in which 21 adults with CF and 22 control subjects underwent lung-volume quantification using multidetector CT. Voxel densities were divided into 4 bands: -1,000 to -900 Hounsfield units (HU) (hyperaerated region), -900 to -500 HU (normally aerated region), -500 to -100 HU (poorly aerated region), and -100 to 100 HU (non-aerated region). In addition, all participants performed pulmonary function tests including spirometry, body plethysmography, diffusion capacity for carbon monoxide, and the forced oscillation technique.

RESULTS:

Adults with CF had more non-aerated regions and poorly aerated regions with lung-volume quantification using multidetector CT than controls. Despite these abnormalities, total lung volume measured by lung-volume quantification using multidetector CT did not differ between subjects and controls. Total lung capacity (TLC) measured by body plethysmography correlated with both total lung volume (rs = 0.71, P < .001) and total air volume (rs = 0.71, P < .001) as measured with lung-volume quantification using multidetector CT. While the hyperaerated regions correlated with the functional markers of gas retention in the lungs (increased residual volume (RV) and RV/TLC ratio), the poorly aerated regions correlated with the resistive parameters measured by the forced oscillation technique (increased intercept resistance and mean resistance). We also observed a correlation between normally aerated regions and highest pulmonary diffusion values (rs = 0.68, P < .001).

CONCLUSIONS:

In adults with CF, lung-volume quantification using multidetector CT can destimate the lung volumes of compartments with different densities and determine the aerated and non-aerated contents of the lungs; furthermore, lung-volume quantification using multidetector CT is clearly related to pulmonary function parameters.

KEYWORDS:

cystic fibrosis; diagnostic imaging; forced oscillation technique; respiratory function tests

PMID:
29208759
DOI:
10.4187/respcare.05815

Conflict of interest statement

The authors have disclosed no conflicts of interest.

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