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Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
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Correlation between Computed Tomographic Analysis and Pulmonary Function Measurements in Patients with Relapsing

Hajime Tsuruoka1, Hiroshi Handa1, Tsuneo Yamashiro2,3

  • 1Division of Respiratory Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.

Respiration; International Review of Thoracic Diseases
|January 21, 2021
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Summary

Tracheal volume (TrV) better reflects pulmonary function in relapsing polychondritis (RP) patients than minimum tracheal cross-sectional area (mtCSA). TrV correlates with spirometry and impulse oscillometry, offering a more comprehensive assessment of airway abnormalities in RP.

Keywords:
Computed tomographyImpulse oscillometryRelapsing polychondritisSpirometryTracheobronchial malacia

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Rheumatology

Background:

  • Relapsing polychondritis (RP) is a rare systemic autoimmune disease.
  • Cartilaginous involvement affects multiple organs, with airway compromise being a critical prognostic indicator.
  • Assessing the extent of tracheal involvement in RP is crucial for patient management.

Purpose of the Study:

  • To introduce and evaluate tracheal volume (TrV) as a novel CT-based measurement for assessing tracheal abnormalities in RP.
  • To compare the efficacy of TrV with minimum tracheal cross-sectional area (mtCSA) in correlating with pulmonary function tests.
  • To investigate the relationship between CT-derived measurements and spirometry, including impulse oscillometry (IOS).

Main Methods:

  • Retrospective analysis of chest CT scans, spirometry, and IOS data from RP patients (April 2004 - March 2019).
  • Calculation of TrV, TrV/tracheal length (TrV/TL), and mtCSA from CT images.
  • Correlation analysis between CT measurements and pulmonary function parameters.

Main Results:

  • Spirometry revealed moderate airway obstruction in the included RP patients.
  • Peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV1) showed strong correlations with both mtCSA and TrV.
  • Impulse oscillometry parameters (respiratory resistance at 5 Hz [R5] and 20 Hz [R20], resonant frequencies [RFs]) significantly correlated with TrV, but not mtCSA.

Conclusions:

  • Tracheal volume (TrV) demonstrates a strong correlation with spirometric measurements in RP patients.
  • IOS parameters, indicative of airway resistance, correlate specifically with TrV, suggesting its superior utility.
  • TrV assessment provides a more comprehensive evaluation of pulmonary function in RP compared to mtCSA.