The acoustic characteristics of fine crackles predict honeycombing on high-resolution computed tomography

Autor: Kosei Nishitsuji, Yasushi Obase, Yuji Ishimatsu, Ryo Kozu, Hiroshi Mukae, Sueharu Miyahara, Shunpei Shiwa, Tomoya Sakai, Shota Nakashima, Hiroshi Ishimoto, Noriho Sakamoto, Kazuto Ashizawa, Toshikazu Fukumitsu
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
High-resolution computed tomography
Pulmonary fibrosis
Diagnosis
Differential
03 medical and health sciences
0302 clinical medicine
Japan
Usual interstitial pneumonia
Image Processing
Computer-Assisted
medicine
Humans
030212 general & internal medicine
Honeycombing
Respiratory sounds
Lung sounds
Aged
Respiratory Sounds
lcsh:RC705-779
medicine.diagnostic_test
Time-expanded waveform analysis
business.industry
Signal Processing
Computer-Assisted
Auscultation
lcsh:Diseases of the respiratory system
Frequency
Middle Aged
medicine.disease
Confidence interval
Logistic Models
ROC Curve
030228 respiratory system
Onset timing
Multivariate Analysis
Female
Crackles
Radiology
medicine.symptom
Lung Diseases
Interstitial
Tomography
X-Ray Computed
business
Fine crackles
Research Article
Zdroj: BMC Pulmonary Medicine, Vol 19, Iss 1, Pp 1-8 (2019)
BMC Pulmonary Medicine
ISSN: 1471-2466
Popis: Background: Honeycombing on high-resolution computed tomography (HRCT) is a distinguishing feature of usual interstitial pneumonia and predictive of poor outcome in interstitial lung diseases (ILDs). Although fine crackles are common in ILD patients, the relationship between their acoustic features and honeycombing on HRCT has not been well characterized. Methods: Lung sounds were digitally recorded from 71 patients with fine crackles and ILD findings on chest HRCT. Lung sounds were analyzed by fast Fourier analysis using a sound spectrometer (Easy-LSA; Fukuoka, Japan). The relationships between the acoustic features of fine crackles in inspiration phases (onset timing, number, frequency parameters, and time-expanded waveform parameters) and honeycombing in HRCT were investigated using multivariate logistic regression analysis. Results: On analysis, the presence of honeycombing on HRCT was independently associated with onset timing (early vs. not early period; odds ratios [OR] 10.407, 95% confidence interval [95% CI] 1.366-79.298, P = 0.024), F99 value (the percentile frequency below which 99% of the total signal power is accumulated) (unit Hz = 100; OR 5.953, 95% CI 1.221-28.317, P = 0.029), and number of fine crackles in the inspiratory phase (unit number = 5; OR 4.256, 95% CI 1.098-16.507, P = 0.036). In the receiver-operating characteristic curves for number of crackles and F99 value, the cutoff levels for predicting the presence of honeycombing on HRCT were calculated as 13.2 (area under the curve [AUC], 0.913; sensitivity, 95.8%; specificity, 75.6%) and 752 Hz (AUC, 0.911; sensitivity, 91.7%; specificity, 85.2%), respectively. The multivariate logistic regression analysis additionally using these cutoff values revealed an independent association of number of fine crackles in the inspiratory phase, F99 value, and onset timing with the presence of honeycombing (OR 33.907, 95% CI 2.576-446.337, P = 0.007; OR 19.397, 95% CI 2.311-162.813, P = 0.006; and OR 12.383, 95% CI 1.443-106.293, P = 0.022; respectively). Conclusions: The acoustic properties of fine crackles distinguish the honeycombing from the non-honeycombing group. Furthermore, onset timing, number of crackles in the inspiratory phase, and F99 value of fine crackles were independently associated with the presence of honeycombing on HRCT. Thus, auscultation routinely performed in clinical settings combined with a respiratory sound analysis may be predictive of the presence of honeycombing on HRCT.
BMC Pulmonary Medicine, 19(1), art.no.153; 2019
Databáze: OpenAIRE
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