Assessment Of Changes In Regional Xenon-Ventilation, Perfusion, And Ventilation-Perfusion Mismatch Using Dual-Energy Computed Tomography After Pharmacological Treatment In Patients With Chronic Obstructive Pulmonary Disease: Visual And Quantitative Analysis

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.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): COPD

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 25 September 2019

Publication date Collection: 2019

Volume: 14

Pages: 2195-2203

Affiliations

[1 ]Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine , Songpa-Gu, Seoul 138-736, South Korea

[2 ]Department of Pulmonary and Critical Care Medicine, Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine , Songpa-Gu, Seoul 138-736, South Korea

[3 ]Department of Radiology, Ansan Hospital, Korea University College of Medicine , Danwon-gu, Ansan-si, Gyeonggi-do, Korea

Author notes

Correspondence: Sang Min Lee Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center , 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul138-736, South KoreaTel [phone]Fax [phone] Email [e-mail]

Article

Publisher ID: 210555

DOI: 10.2147/COPD.S210555

PMC ID: 6768130

Copyright statement: © 2019 Hwang et al.

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

Page count

Figures: 4, Tables: 2, References: 34, Pages: 9

Categories

Subject: Original Research