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Quantitative Assessment of Global and Regional Air Trappings Using Non-Rigid Registration and Regional Specific Volume Change of Inspiratory/Expiratory CT Scans: Studies on Healthy Volunteers and Asthmatics

  • Lee, Eunsol (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seo, Joon Beom (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Hyun Joo (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chae, Eun Jin (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang Min (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Oh, Sang Young (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Namkug (Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2014.08.15
  • Accepted : 2015.02.12
  • Published : 2015.06.01

Abstract

Objective: The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. Materials and Methods: Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. ${\Delta}SV$, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, ${\Delta}SV_{0.4}$ and ${\Delta}SV_{0.5}$, were defined as volume fraction of lung below 0.4 and 0.5 ${\Delta}SV$, respectively. To assess the gravity effect of air-trapping, ${\Delta}SV$ values of anterior and posterior lung at three different levels were measured and ${\Delta}SV$ ratio of anterior lung to posterior lung was calculated. Color-coded ${\Delta}SV$ map of the whole lung was generated and visually assessed. Mean ${\Delta}SV$, ${\Delta}SV_{0.4}$, and ${\Delta}SV_{0.5}$ were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. Results: Mean ${\Delta}SV$, ${\Delta}SV_{0.4}$, and ${\Delta}SV_{0.5}$ in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). ${\Delta}SV$ values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as ${\Delta}SV_{0.5}$ and ${\Delta}SV_{0.4}$, showed negative strong correlation with $FEF_{25-75}$, $FEV_1$, and $FEV_1$/FVC. ${\Delta}SV$ map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). Conclusion: Quantitative assessment of ${\Delta}SV$ (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.

Keywords

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