Quantitative analysis of lung volume and airways with 3D-MDCT in subjects with a COPD-associated diplotype
- 주제(키워드) chronic obstructive pulmonary disease , genome wide association study , quantification study , computed tomography
- 발행기관 고려대학교 대학원
- 지도교수 이기열
- 발행년도 2013
- 학위수여년월 2013. 2
- 학위구분 박사
- 학과 일반대학원 의학과
- 세부전공 영상의학과학
- 원문페이지 32 p
- 실제URI http://www.dcollection.net/handler/korea/000000038754
- 본문언어 영어
- 제출원본 000045743203
초록/요약
Purpose: This study assesses a quantitative analysis of lung volume and airways with 3 dimensional multi-detector computed tomography (3D-MDCT) in subjects with subclinical COPD and diplotypes that have been associated with chronic obstructive pulmonary disease (COPD). Materials and methods: One hundred sixty-two subjects (162 males; mean age, 58±7 years) with the high-risk diplotype CTGA (n=85) and reference diplotype TCAG (n=77) were selected from a cohort of 5,020 using a genome-wide association study and were included in our study. The risk and reference diplotypes were identified by analyzing the association between the genetic variants and the forced expiratory volume in the first second (FEV1) to forced vital capacity (FVC) ratio (FEV1/FVC). We performed 3D-MDCT scans using a single protocol and vendor in order to obtain a quantitative analysis of lung volume and airways. We measured total lung volume (TLV), emphysema volume (EV), emphysema index (EI), mean lung density (MLD), and the normal lung volume index (NLVI) using in-house software. Bronchial cross-sectional wall area (WA), luminal area (LA), and the wall-to-lumen area ratio (WA%) were measured. We compared 3D-MDCT quantification data for the lung and airways between the risk and reference groups using two-sample t-tests. Results: The subjects with the high-risk diplotype (CTGA) had significantly higher TLV (5027.7 ±935.4 mL, p=0.04), EV (115.2±126.7mL, p=0.04) and EI (2.11±2.06%, p=0.03) than the reference TCAG group (TLV, 4707± 984.0mL; EV, 78.8±89.8mL; EI, 1.49±1.49). MLD (-840.9±23.7HU) and NLVI (0.98±0.02%) were significantly lower (p<0.05) in the risk group than in the reference group (MLD, -829.4±32.1HU; NLVI, 0.99±0.01). However, in the analysis of airways, WA, LA and WA% were not significantly different between the two groups. Conclusion: Subjects with subclinical COPD and the high-risk diplotype had higher TLV, EV, and EI. On the other hand, MLD and NLVI were significantly lower than in the reference group. CT quantification of lung volume and the airways correlated with the GWAS results. CT quantification of the lung and airways may allow for the development of proper guidelines for the management of subclinical subjects with the high-risk COPD gene, with the goal of preventing progression to symptomatic COPD, and in the management of symptomatic COPD patients.
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Index
Abstract i
I. Introduction 1
II. Materials and Methods 3
III. Results 7
IV. Discussion and conclusion 9
V. Summary 13
VI. References 21
