Assessment Of Changes In Regional Xenon-Ventilation, Perfusion, And Ventilation-Perfusion Mismatch Using Dual-EnergyComputed Tomography After Pharmacological Treatment In Patients With Chronic Obstructive Pulmonary Disease: Visual And Quantitative Analysis
- Authors
- Hwang, Hye Jeon; Lee, Sang Min; Seo, Joon Beom; Lee, Jae Seung; Kim, Namkug; Kim, Cherry; Oh, Sang Young; Lee, Sei Won
- Issue Date
- 2019
- Publisher
- DOVE MEDICAL PRESS LTD
- Keywords
- chronic obstructive pulmonary disease; dual-energy computed tomography; ventilation-perfusion mismatch; pharmacotherapy
- Citation
- INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, v.14, pp.2195 - 2203
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
- Volume
- 14
- Start Page
- 2195
- End Page
- 2203
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/68947
- DOI
- 10.2147/COPD.S210555
- ISSN
- 1176-9106
- Abstract
- Purpose: To assess changes in regional ventilation (V), perfusion (Q), and V-Q mismatch in patients with chronic obstructive pulmonary disease (COPD) after pharmacologic treatment using combined xenon-enhanced V and iodine-enhanced Q dual-energy CT (DECT). Patients and methods: Combined V and Q DECT were performed at baseline and after three-month pharmacologic treatment in 52 COPD patients. Anatomically co-registered virtual non-contrast images, V, Q, and V/Q(ratio) maps were obtained. V/Q pattern was visually determined to be matched, mismatched, or reversed-mismatched and compared with the regional parenchymal disease patterns of each segment. DECT parameters for V, Q, and V-Q imbalance were quantified. Results: The parenchymal patterns on CT were not changed at follow-up. The segments with matched V/Q pattern were increased (80.2% to 83.6%) as the segments with reversed-mismatched V/Q pattern were decreased with improving ventilation (17.6% to 13.8%) after treatment. Changes of V/Q patterns were mostly observed in segments with bronchial wall thickening. Compared with patients without bronchial wall thickening, the quantified DECT parameters of V-Q imbalance were significantly improved in patients with bronchial wall thickening (p < 0.05). Changes in forced expiratory volume in one second after treatment were correlated with changes in the quantified DECT parameters (r = 0.327-0.342 or r = -0.406 and -0.303; p < 0.05). Conclusion: DECT analysis showed that the V-Q imbalance was improved after the pharmacological treatment in COPD patients, although the parenchymal disease patterns remained unchanged. This improvement of V-Q imbalance may occur mostly in the areas with bronchial wall thickening.
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