视觉和定量间歇性肺异常在COPD基因中的进展
Rachel K Putman1, Jonathan A Rose2, Ruben San José Estepar3
1Brigham and Women's Hospital, Pulmonary and Critical Care Medicine, Boston, Massachusetts, United States; RPUTMAN@BWH.HARVARD.EDU.
量化间歇性异常 (QIA) 的纵向变化预测了吸烟者间歇性肺异常 (ILA) 的成像进展和死亡率. 基线QIA和FVC没有预测进展,但增加的QIA与不良结果相关.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
- 定量成像技术 定量成像技术
背景情况:
- 在CT扫描中的间歇性肺异常 (ILA) 可能表明早期肺纤维化.
- 定量间歇性异常 (QIA) 提供了对肺损伤的自动评估.
- 视觉和定量ILA评估对进展的综合预测价值是未知的.
研究的目的:
- 评估定量成像在预测ILA进展中的实用性.
- 评估吸烟者的ILA进展和不良临床结果之间的关联.
- 为了确定是否结合视觉和定量评估可以改善预测.
主要方法:
- 从COPDGene队伍中进行的胸部CT扫描分析了ILA的存在,亚型和5年内的进展.
- 测量了定量间歇性异常 (QIA) 和强迫生命能力 (FVC).
- 使用多变量逻辑回归和Cox比例危险模型来评估与ILA进展和死亡率的关联.
主要成果:
- 在4373名参与者中,544名 (12%) 患有ILA,其中391名 (72%) 显示视觉进展.
- 特定的成像特征,如引支气管切开症,与进展相关 (OR=3.1).
- 基线QIA和FVC没有预测进展,但视觉进展与纵向QIA增加相关 (6.5%的差异).
- 增加的QIA独立预测增加的死亡率 (HR=1.05).
结论:
- 基线定量测量 (QIA,FVC) 没有预测视觉ILA的进展.
- 在QIA的纵向变化与成像进展相关.
- 随着时间的推移,QIA的增加与不良临床结果有关,包括死亡率,独立于FVC下降.
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