J Korean Soc Radiol.  2018 Jun;78(6):371-379. 10.3348/jksr.2018.78.6.371.

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

• Han JY
• Lee KN
• Kang EJ
• Baek JW

• KMID: 2412355
• DOI: http://doi.org/10.3348/jksr.2018.78.6.371

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.

MeSH Terms

Diaphragm
Emphysema*
Forced Expiratory Volume
Humans
Linear Models
Male*
Multidetector Computed Tomography
Pulmonary Disease, Chronic Obstructive
Respiratory Function Tests
Respiratory Muscles*
Retrospective Studies
Vital Capacity

Figure

• 

  Fig. 1. Sample CT scans used to measure cross sectional area of respiratory muscles. A. The cross sectional area of PM (red) and PN (blue) are measured at the level of the claviculomanubrial joint. B. The cross sectional area of ITC (purple), SA (green), and LD (yellow) are measured at the level of right inferior pulmonary vein. C. The cross sectional area of DC (orange) is measured at the retrocrural area at the level of origin of the celiac trunk. DC = diaphragm crus, ITC = intercostalis, LD = latissimus dorsi, PM = pectoralis major, PN = pectoralis minor, SA = serratus anterior

• 

  Fig. 2. Correlation of CT measurements of serratus anterior according to visual assessment of emphysema (A, B) and FEV1/FVC (C, D). FEV1/FVC = forced expiratory volume in 1 second/forced vital capacity

Reference

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