CT assessment of lobar heterogenity and fissure integrity in pulmonary emphysema for bronchoscopic lung volume reduction with valve
| Autor: | Teruomi Miyazawa, Fumihiro Asano, Hiroshi Handa, Takuya Sobajima, Tomoya Kato, Masamichi Mineshita, Yoshihiko Matusno, Atsunori Masuda, Akifumi Tsuzuku, Anri Murakami |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
COPD Heterogeneous group medicine.diagnostic_test business.industry Pulmonary emphysema Pulmonary disease Computed tomography respiratory system medicine.disease Bronchoscopic lung volume reduction respiratory tract diseases Surgery medicine Homogeneous group In patient business |
| Zdroj: | 1.3 Imaging. |
| Popis: | Background: Recently, advances in bronchoscopic techniques such as bronchial valves have been increasing in value for Chronic Obstructive Pulmonary Disease (COPD). Bronchial valve therapy has been proven to be useful for patients with lobar heterogeneous emphysema and complete fi ssure. In this study, we measured emphysema scores and fi ssure integrity in patients with emphysema, then classifi ed these based on computed tomography image patterns to examine which patients were candidates for bronchial valve therapy. Methods: Between February 2013 and May 2014, we studied 40 consecutive patients with CT-detected emphysema. Quantitative CT imaging analysis was performed using software. Emphysema scores per lobe were converted to the Likert scale, where a score of 1 equals 1 to 25%, 2 (26 to 50%), 3 (51 to 75%), and 4 (76 to 100%). Lobar heterogenity of more than or equal to a 2-unit difference was needed between the adjacent lobes. The heterogeneous group was divided into complete and incomplete fi ssure groups. Fissure integrity scores of ≧80% and < 80% were defi ned as complete and incomplete fi ssure integrity, respectively. Results: Forty patients were classifi ed into either a heterogeneous group (5 patients), or a homogeneous group (35 patients). The heterogeneous group was then divided into a complete fi ssure group (2 patients) or incomplete fi ssure group (3 patients). In the homogeneous group, 14 patients were classifi ed into the complete fi ssure group and 21 patients to the incomplete fi ssure group. This study revealed that, of the 40 patients who were indicated, only 2 patients met the criteria of heterogeneous and complete fi ssure for bronchial valve therapy. Conclusion: We attempted to select candidates for bronchoscopic lung volume reduction with valve using VIDA Apollo software. However, we could not recruit a suffi cient number of outpatients with CT-detected emphysema. |
| Databáze: | OpenAIRE |
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