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(Chest. 1994;106:806-813.)
© 1994 American College of Chest Physicians

Correlation of Quantitative CT With Selective Alveolobronchogram and Pulmonary Function Tests in Emphysema

Yuji Watanuki M.D.1; Shunsuke Suzuki M.D.1; Masanori Nishikawa M.D.1; Akira Miyashita M.D.1; and Takao Okubo M.D.1

1 From the First Department of Internal Medicine, Yokohama City University School of Medicine, Yokohama, Japan

Background: Emphysema diagnosed by computed tomography (CT) has been reported to be correlated with morphologic data from autopsied lungs or resected lobes. However, autopsied lungs or resected lobes are quite different from lungs in vivo. We examined the correlation between a quantitative analysis of CT and the in vivo morphologic degree of emphysema (selective alveolobronchography [SAB]) in patients with COPD.

Methods: We measured the mean attenuation value (MAV) of the lung fields between minus700 HU and minus1,024 HU to exclude the effect of high-density structures in 21 patients with COPD. Low attenuation, greater than 2 SD below the mean value of five normal healthy subjects, was used as an index of emphysema. To quantitate the amount of emphysema, the relative area of low attenuation to the area of the entire lung field (2SD percent) was measured. The morphologic degree of emphysema was determined from the diameter of ring shadow (DR) of SAB. We also examined the relationship between CT data and pulmonary function tests.

Results: The DR was highly correlated with the CT indexes of MAV and 2SD percent; (r=minus0.894, p<0.001, and r=0.890, p<0.001). Both MAV and 2SD percent were correlated with pulmonary function tests such as Dco, FEV1, and residual volume (r>0.60).

Conclusions: The MAV and relative area of emphysema obtained from CT density measurements accurately assess the severity of emphysema in patients with COPD as well as SAB.

Submitted on July 1, 1993
Accepted on January 6, 1994




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