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Characteristic features of pulmonary function test, CT volume analysis and MR perfusion imaging in COPD patients with different HRCT phenotypes

Authors

  • Li Fan,

    1. Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, China
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  • Yi Xia,

    1. Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, China
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  • Yu Guan,

    1. Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, China
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  • Tie-feng Zhang,

    1. Department of Respiration Medicine, Changzheng Hospital of the Second Military Medical University, Shanghai, China
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  • Shi-yuan Liu

    Corresponding author
    1. Department of Radiology, Changzheng Hospital of the Second Military Medical University, Shanghai, China
    • Correspondence

      Shi-yuan Liu, MD, Department of Radiology, ChangZheng Hospital, Second Military Medical University, no. 415 Fengyang Road, 200003 Shanghai, China.

      Tel: +86 21 8188 6011

      Fax: +86 21 6358 7668

      email: lsy0930@163.com

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  • Authorship and contributorship

    Li Fan, Yi Xia and Yu Guan contributed equally to this study.

    Li Fan, wrote the paper and analyzed data; Yi Xia, performed the research and analyzed the data; Yu Guan, performed the research and analyzed the data; Tie-feng Zhang, collected the data; and Shi-yuan Liu, studied the design.

  • Ethics

    The study was accepted by the local ethics committee, and prospective written informed consent for study participation was obtained from all subjects after the study purpose was fully explained.

  • Conflict of interest

    There is no any actual or potential conflict of interest to be declared for all of us.

    Li Fna, None declared.

    Yi Xia, None declared.

    Yu Guan, None declared.

    Tie-feng Zhang, None declared.

    Shi-yuan Liu, None declared.

Abstract

Introduction

Computed tomography (CT) and magnetic resonance imaging (MRI) can provide detailed anatomic structures and quantitative function information for chronic obstructive pulmonary disease (COPD).

Objectives

To prospectively clarify characteristics of pulmonary function test (PFT), CT volume parameters and magnetic resonance (MR) perfusion imaging in COPD patients with different high-resolution computed tomography (HRCT) phenotypes.

Methods

Sixty-two patients performed PFT, CT and MR perfusion imaging. COPD was classified into three phenotypes according to HRCT quantitative findings: A, E and M phenotype. Total lung volume (TLV), total emphysema volume (TEV) and emphysema index (EI) were quantitated by HRCT. In cases of perfusion defects (PDs), the shape and size were evaluated. The contrast between the normal lung and PDs was quantified by calculating their signal intensity ratio (RSI = SIPD/SInormal). The correlation was performed between PFT, CT and MR perfusion.

Results

There were 42 A phenotype, 9 E phenotype and 11 M phenotype. There was significant difference in forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) between A and M phenotype (P < 0.05). TEV and EI of A phenotype (0.4 ± 0.4 L and 8.0% ± 4.3%) were lower than those of E (1.0 ± 0.3 L and 18.6% ± 3.2%) or M phenotype (0.9 ± 0.2 L and 17.5% ± 1.7%). MR perfusion images showed circumscribed or diffuse patchy PDs. RSI of A phenotype was higher than that of E phenotype (20.3% ± 8.5% vs 11.8% ± 5.4%; P = 0.006). TEV and EI were moderate negatively correlated with diffusion function parameters. RSI was strongly correlated with FEV1% (A) and FEV1/FVC (M). FEV1/FVC was strongly correlated with TEV or EI (E).

Conclusion

There were different features and correlations between PFT, CT volume and MR perfusion in different phenotype, indicating each phenotype may have novel imaging method guiding clinical management.

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