| Part1Quantitative CT analysis of the PAin GOLD I-IV COPD【Objectives】 Analyze the difference between the grade1-4PA diameters of I-IVCOPD patients.【Materials and Methods】48patients were collected and divided intograde I-IV according to the global initiative of GOLD. Measuring the PA of A1, LA2/RA2,RUA3, LLA3/RLA3, RUA4, LUA4, RMA4, LLA4/RLA4of all patients, by the methodsof multi-planar reconstruction (MPR) and curved planar reconstruction (CPR), in order toanalyze the difference of grade1-4PAbetween grade I-IV COPD patients.【Results】Thediameters of A1between GOLD I and II, II and III had statistical difference (respectively,p=0.009, p=0.002). The diameters of RA2between GOLD I and II, II and III, II and IVhad statistical difference (respectively, p=0.003, p=0.034, p=0.041); the diameters of LA2between GOLD II and III had statistical difference (p=0.043). The diameters of RLA3between GOLD I and III, I and IV had statistical difference (respectively, p=0.004,p=0.009); the diameters of LLA3between GOLD I and III, I and IV had statisticaldifference (respectively, p=0.024, p=0.003). The diameters of RMA4between GOLD I andIII, I and IV, II and IV, III and IV had statistical difference (respectively, p=0.019, p=0.000,p=0.006, p=0.027); the diameters of RLA4between GOLD I and III, I and IV, II and IVhad statistical difference (respectively, p=0.000, p=0.000, p=0.006); the diameters ofLUA4between GOLD I and II, II and IV had statistical difference (respectively, p=0.015,p=0.006); the diameters of LLA4between GOLD I and IV, II and IV had statisticaldifference (respectively, p=0.015, p=0.018).【Conclusion】As the PA diameters becamethinner, the difference between the GOLD I-IV was more obvious. Part2The relation between the diameter of PAand PFT, CTvolumetric parameters in COPD【Objectives】Evaluate the relationship between the PA and PFT, CT volumetricparameters in COPD patients.【Materials and Methods】Measuring the diameters ofA1, LA2, RA2, RUA3, LLA3, RLA3, RUA4, LUA4, RMA4, LLA4, RLA4in48COPDpatients, by MPR and CPR. PFT parameters including FEV1, FEV1/Predict, FVC,FEV1/FVC, MEF25and MEF25/Predict were measured by spirometer. TLV, TEV and EIwere quantitated by Philips Lung Density software. The correlation was performedbetween the grade1-4PA, PFT and CT volumetric parameters.【Results】(1) Relationbetween the diameter of PA and PFT: RLA3was mild negatively correlated with FEV1,FEV1/Predict, FVC, FEV1/FVC, MEF25and MEF25/Predict (respectively,r=-0.375,p=0.009； r=-0.342,p=0.017； r=-0.334,p=0.020； r=-0.334,p=0.020；r=-0.299,p=0.039；r=-0.327,p=0.024). LLA3was mild negatively correlated with FEV1,FEV1/Predict, FEV1/FVC, MEF25and MEF25/Predictct (respectively, r=-0.289,p=0.046；r=-0.398,p=0.005；r=-0.486,p=0.000；r=-0.303,p=0.036；r=-0.314,p=0.030). RMA4wasmoderate positively correlated with FEV1, FEV1/Predict, FVC, FEV1/FVC andMEF25/Predict (respectively, r=0.532,p=0.000；r=0.537,p=0.000；r=0.470,p=0.001；r=0.485,p=0.000；r=0.565,p=0.000). RLA4was moderate positively correlated with FEV1,FEV1/Predict, FVC, FEV1/FVC and MEF25/Predict (respectively, r=0.622,p=0.000；r=0.667,p=0.000；r=0.401,p=0.005；r=0.716,p=0.000；r=0.700,p=0.000). LLA4wasmoderate positively correlated with FEV1, FEV1/Predict, FEV1/FVC, MEF25andMEF25/Predict (respectively, r=0.378，p=0.008；r=0.412,p=0.004；r=0.557,p=0.000；r=0.409,p=0.004；r=0.437,p=0.002). For A1, the diameters of GOLD I were moderatecorrelated with FEV1/FVC, MEF25/Predict (respectively, r=0.627,p=0.029；r=0.683,p=0.014); the diameters of GOLD III were moderate correlated with MEF25(r=0.613,p=0.034).For RA2, the diameters of GOLD I were moderate correlated withFEV1/FVC and MEF25/Predict (respectively, r=0.601,p=0.039；r=0.629,p=0.028). ForRUA3, the diameters of GOLD I were moderate correlated with MEF25(r=0.626,p=0.030); the diameters of GOLD III were moderate correlated with FVC (r=0.608,p=0.036); the diameters of GOLD IV were moderate correlated with FEV1, FEV1/Predictand FVC (respectively, r=0.743,p=0.006；r=0.699,p=0.011；r=0.774,p=0.003). For LLA3,the diameters of GOLD I were moderate correlated with FEV1, FVC, MEF25(respectively,r=0.594,p=0.042；r=0.589,p=0.044；r=0.661,p=0.019). For RUA4, the diameters of GOLDIV were moderate correlated with FEV1(r=0.611, p=0.035). For RLA4，the diameters ofGOLD II were moderate correlated with FEV1/FVC and MEF25/Predict (respectively,r=0.718,p=0.009；r=0.637,p=0.026); the diameters of GOLD III were moderate to stronglycorrelated with FVC, FEV1/FVC (respectively, r=-0.705,p=0.010；r=0.866,p=0.000). For LLA4, the diameters of GOLD III were moderate correlated with MEF25(r=0.754,p=0.005); the diameters of GOLD IV were moderate correlated with FVC, FEV1/FVC andMEF25/Predict (r=-0.642,p=0.024；r=0.771,p=0.003；r=0.602,p=0.038).(2) Relationbetween the diameter of PA and CT volumetric parameters: RLA3were mildpositively correlated with TEV and EI (respectively, r=0.415,p=0.003；r=0.420,p=0.003);LLA3were moderate positively correlated with TLV, TEV and EI (respectively,r=0.551,p=0.000；r=0.545,p=0.000；r=0.468,p=0.001). RMA4were mild negativelycorrelated with TLV, TEV and EI (respectively, r=-0.366,p=0.011; r=-0.494,p=0.000;r=-0.505,p=0.000); RLA4were moderate negatively correlated with TLV, TEV and EI(respectively, r=-0.482,p=0.001; r=-0.689,p=0.000; r=-0.717,p=0.000); LLA4were mildnegatively correlated with TLV, TEV and EI (respectively, r=-0.437,p=0.002;r=-0.515,p=0.000; r=-0.504,p=0.000). For RLA3, the diameters of GOLD III weremoderate positively correlated with TEV, EI (respectively, r=0.585, p=0.046;r=0.673,p=0.017). For LLA3，the diameters of GOLD II-III were moderate positivelycorrelated with TLV (respectively, r=0.676,p=0.016; r=0.643,p=0.024); the diameters ofGOLD III were moderate positively correlated with TEV (r=0.706,p=0.010). For RLA4，the diameters of III were moderate negatively correlated with TLV (r=-0.653,p=0.021); thediameters of GOLD II、III were moderate negatively correlated with TEV、EI (respectively,r=-0.662,p=0.019; r=-0.674,p=0.016; r=-0.613,p=0.034; r=-0.614,p=0.034).【Conclusion】(1) The grade3PA were mild negatively correlated with PFT. The grade4PA wasmoderate positively correlated with PFT. The FEV1/Predict, FEV1/FVC were mostlycorrelated with the grade3-4PA among the PFT. The correlation between the grade4PAand PFT were higher than that with grade3PA. The correlation between the PFT and grade1-2PA of GOLD I was higher than that with grade1-2PA of GOLD II-IV; the correlationbetween the PFT and grade3-4of GOLD III-IV was higher than that with grade3-4PA ofGOLD I-II. In early phase the correlation between the bigger PA and PFT was higher,while in later phase the correlation between the narrower PAand PFT was higher.(2) Somegrade3PA were moderate positively correlated with CT volumetric parameters, the grade4PA except RUA4and LUA4were mild to moderate negatively correlated with CTvolumetric parameters. The correlation between grade3-4PA and TEV, EI were higherthan that with TLV. The correlation between grade4PA and EI was higher than that withgrade3PA. With the grade of GOLD increased, the correlation between the PA and CTvolumetric parameters enlarged. Part3The comparative CT volumetric analysis between the COPDpatients and smokers with normal PFT【Objectives】 Analyze the grade1-4PA difference between COPD and smokerswith normal PFT.【Materials and Methods】Measuring the diameters ofA1, LA2, RA2,RUA3, LLA3, RLA3, RUA4, LUA4, RMA4, LLA4, RLA4in48COPD patients and27smokers with normal PFT, by using MPR and CPR. TLV, TEV and EI were quantitated byPhilips Lung Density software. Evaluating the difference of the grade1-4PA and CTvolumetric parameters between emphysematous smokers and non-emphysematoussmokers.【Results】The RUA4, RLA4between the smokers with normal PFT and GOLDI COPD patients had statistical difference (respectively, p=0.038，p=0.000); the LLA3、RUA4、LUA4between the smokers with normal PFT and GOLD II COPD patients hadstatistical difference (respectively, p=0.013，p=0.028，p=0.000); theA1、LA2、RLA3、LLA3、RUA4、RMA4、LUA4between the smokers with normal PFT and GOLD III COPDpatients had statistical difference (respectively, p=0.002，p=0.043，p=0.002，p=0.011，p=0.046，p=0.009，p=0.017); the RLA3、LLA3、RUA4、RMA4and RLA4、LLA4betweenthe smokers with normal PFT and GOLD IV COPD patients had statistical difference(respectively, p=0.005, p=0.001, p=0.017, p=0.000, p=0.020, p=0.001). The RMA4, RLA4between the emphysematous smokers and the non-emphysematous smokers had statisticaldifference (respectively, p=0.047; p=0.028). The TLV between the smokers with normalPFT and GOLD IV COPD patients had statistical difference (p=0.000); the TEV betweenthe smokers with normal PFT and GOLD II-IV COPD patients had statistical difference(respectively, p=0.002, p=0.000, p=0.000); the EI between the smokers with normal PFTand GOLD I-IV COPD patients had statistical difference (respectively, p=0.039; p=0.000;p=0.000; p=0.000).【Conclusions】The grade4PAbetween the smokers with normal PFTand GOLD I COPD patients had statistical difference, the grade3-4PA between thesmokers with normal PFT and GOLD II COPD patients had statistical difference, the grade1,3,4PA between smokers with normal PFT and GOLD III-IV COPD patients had statistical difference. Small vessel remodeling appeared in the early phase of COPD, withthe time went on, the abnormality became more obvious. Compared with TLV, TEV and EIcan distinguish emphysematous smokers and COPD patients (GOLD I, II); EI was superiorto TEV in distinguishing emphysematous smokers and GOLD I COPD patients. The extentof emphysema affected small pulmonary arteries remodeling. |
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