Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Quantitative Computed Tomography Assessment of Respiratory Muscles in Male Patients Diagnosed with Emphysema

폐기종 환자에서 호흡 근육의 양적 CT 평가

  • Han, Ji-Yeon (Department of Radiology, Dongnam Institute of Radiological & Medical Sciences) ;
  • Lee, Ki-Nam (Department of Radiology, Dong-A University Hospital) ;
  • Kang, Eun-Ju (Department of Radiology, Dong-A University Hospital) ;
  • Baek, Jin Wook (Department of Radiology, Inje University College of Medicine, Busan Paik Hospital)
  • 한지연 (동남권원자력의학원 영상의학과) ;
  • 이기남 (동아대학교병원 영상의학과) ;
  • 강은주 (동아대학교병원 영상의학과) ;
  • 백진욱 (인제대학교 의과대학 부산백병원 영상의학과)
  • Received : 2017.09.04
  • Accepted : 2018.02.15
  • Published : 2018.06.01
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Abstract

Purpose: The aim of this study was to accurately evaluate the significance and correlation between the clinical severity and the morphologic feature of respiratory muscles in patients with emphysema as noted using computed tomography (CT). Materials and Methods: The cross sectional area (CSA) and attenuation of respiratory muscles in the patients with emphysema (n = 71) were subsequently retrospectively reviewed. The clinical severity for the patients was determined by the value of the actual forced expiratory volume in 1 second/forced vital capacity at the pulmonary function test (PFT). The correlation between the CT measurements with visual assessment of emphysema (VAE), and the PFT values were completed and recorded. The multiple linear regression analysis of each CT measurement on the VAE and PFT values was used to determine the most affective parameters among the recorded and identified CT measurements. Results: The CSA of the pectoralis major (p = 0.002) and subsequently the serratus anterior (p = 0.011) were found to be lower in patients with emphysema than as compared to those in the control group. The CSA and the attenuation of respiratory muscles remained significant for its relation for the VAE and PFT values. As noted, both the VAE and PFT values were mostly contributed by the CSA and attenuation of serratus anterior and attenuation of diaphragm crus among all respiratory muscles. Conclusion: The CT measurement of the patient's respiratory muscles may reflect clinical and visual severity in the patients with emphysema.

목적: 이 연구의 목적은 폐기종 환자에서 임상적 중증도와 CT를 이용한 호흡근육의 형태학적인 변화와의 상관관계를 평가하기 위함이다. 대상과 방법: 71명의 폐기종 환자에서 CT에서 측정한 호흡 근육의 단면적과 감쇠 계수를 후향적으로 평가하여 폐기종 환자와 24명의 대조군과의 차이점을 분석하였다. 임상적 중증도는 폐 기능 검사의 actual forced expiratory volume in 1 second/forced vital capacity ($FEV_1/FVC$) 값으로 정의하였다. 폐기종의 시각적 평가 및 폐 기능 검사와 CT 측정치의 상관관계를 분석하고, CT 측정치 중에 가장 영향력 있는 변수를 알기 위해 폐기종의 시각적 평가와 폐 기능 검사에 대한 각 CT 측정치의 다중선형회귀 분석을 실시하였다. 결과: 폐기종 환자에서 큰가슴근 (p = 0.002), 앞톱니근 (p = 0.011)의 단면적이 대조군과 비교하여 작았다. 신체 비만 계수와 나이를 통제하였을 때, 호흡 근육의 단면적과 감쇠 계수는 폐기종의 시각적 평가와 폐 기능 검사와 유의한 관계를 보였다. 폐 기종의 시각적 평가와 폐기능 검사는 모든 호흡근 중 앞톱니근의 단면적 및 감쇠 계수와 가로막 다리의 감쇠 계수에 가장 큰 영향을 받았다. 결론: 호흡 근육의 CT 측정치는 폐기종 환자의 임상적, 시각적인 중증도를 반영할 수 있다.

Keywords

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