Quantitative Computed Tomography Assessment of Respiratory Muscles in Male Patients Diagnosed with Emphysema

다국어 초록 (Multilingual 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.

참고문헌 (Reference)

1 Barnes PJ, "Systemic manifestations and comorbidities of COPD" 33 : 1165-1185, 2009

2 Orozco-Levi M, "Structure and function of the respiratory muscles in patients with COPD: impairment or adaptation?" 46 : 41s-51s, 2003

3 Steele RH, "Size of the diaphragm in chronic bronchitis" 28 : 55-60, 1973

4 Sharp JT, "Respiratory muscle function in patients with chronic obstructive pulmonary disease: its relationship to disability and to respiratory therapy" 110 : 154-168, 1974

5 Nishimura Y, "Relationship between respiratory muscle strength and lean body mass in men with COPD" 107 : 1232-1236, 1995

6 Cannon DT, "Recruitment of the serratus anterior as an accessory muscle of ventilation during graded exercise" 57 : 127-131, 2007

7 McDonald ML, "Quantitative computed tomography measures of pectoralis muscle area and disease severity in chronic obstructive pulmonary disease. a cross-sectional study" 11 : 326-334, 2014

8 Yu-Sen Huang, "Quantitative Computed Tomography of Pulmonary Emphysema and Ventricular Function in Chronic Obstructive Pulmonary Disease Patients with Pulmonary Hypertension" 대한영상의학회 15 (15): 871-877, 2014

9 조영훈, "Quantitative CT Imaging in Chronic Obstructive Pulmonary Disease: Review of Current Status and Future Challenges" 대한영상의학회 78 (78): 1-12, 2018

10 Smith BM, "Pulmonary emphysema subtypes on computed tomography: the MESA COPD study" 127 : 94.e7-94.e23, 2014

11 Mercadier JJ, "Myosin heavy chain gene expression changes in the diaphragm of patients with chronic lung hyperinflation" 274 : L527-L534, 1998

12 Park MJ, "Mass and fat infiltration of intercostal muscles measured by CT histogram analysis and their correlations with COPD severity" 21 : 711-717, 2014

13 Rho M, "Gender differences on ultrasound imaging of lateral abdominal muscle thickness in asymptomatic adults: a pilot study" 5 : 374-380, 2013

14 Ishikawa S, "Functional morphometry of the diaphragm in patients with chronic obstructive lung disease" 108 : 135-138, 1973

15 Fabbri LM, "From COPD to chronic systemic inflammatory syndrome?" 370 : 797-799, 2007

16 Cassart M, "Effect of chronic hyperinflation on diaphragm length and surface area" 156 : 504-508, 1997

17 Rochester DF, "Determinants of maximal inspiratory pressure in chronic obstructive pulmonary disease" 132 : 42-47, 1985

18 Similowski T, "Contractile properties of the human diaphragm during chronic hyperinflation" 325 : 917-923, 1991

19 윤순호, "Computer-Aided Classification of Visual Ventilation Patterns in Patients with Chronic Obstructive Pulmonary Disease at Two-Phase Xenon-Enhanced CT" 대한영상의학회 15 (15): 386-396, 2014

20 Caron MA, "Comparative assessment of the quadriceps and the diaphragm in patients with COPD" 107 : 952-961, 2009

21 Kim SS, "Chronic obstructive pulmonary disease: lobe-based visual assessment of volumetric CT by using standard images--comparison with quantitative CT and pulmonary function test in the COPDGene study" 266 : 626-635, 2013

22 Levine S, "Cellular adaptations in the diaphragm in chronic obstructive pulmonary disease" 337 : 1799-1806, 1997

23 Lynch DA, "CT-definable subtypes of chronic obstructive pulmonary disease: a statement of the Fleischner Society" 277 : 192-205, 2015

24 Arora NS, "COPD and human diaphragm muscle dimensions" 91 : 719-724, 1987

25 Levine S, "Bioenergetic adaptation of individual human diaphragmatic myofibers to severe COPD" 92 : 1205-1213, 2002

26 Nakayama Y, "Abdominal CT with low tube voltage: preliminary observations about radiation dose, contrast enhancement, image quality, and noise" 237 : 945-951, 2005