본문 바로가기
KERD
논문KCI 등재

만성폐쇄성폐질환에서 흉부 CT의 임상적 이용

Clinical use of chest CT in chronic obstructive pulmonary diseases

박경주
대한내과학회 (The Korean Association Of Internal Medicine)|2009.10|대한내과학회지 (The Korean Journal of Medicine)|제77권 제4호|pp. 407-414

1

조회

0

다운로드

1

인용

0

참고문헌

키워드

Pulmonary disease만성폐쇄성폐질환; 폐기종; 만성기관지염; X선컴퓨터단층촬영; 컴퓨터를 이용한 영상처리Chronic obstructive; Pulmonary emphysema; BronchitisChronic; TomographyX‐ray computed; Image processing; Computer‐Assisted
주제분류내과학

초록

COPD는 흔히 폐공기증과 만성 기관지염이 혼합되어 나타난다. 폐기종은 병리적으로 정의되는 질환으로서 CT를 사용하여 정확한 진단이 가능하다. 또한 폐기종의 종류, 범위와 분포 등의 특성을 파악하는 데도 유용하다. CT를 이용하여 폐실질의 음영도 측정을 시행하면 객관적인 폐기종의 정량화가 가능하며, 중증의 폐기종에 대한 다양한 치료방법을 적용하기 위한 환자의 선택이나 치료결과를 추적하기 위한 정보를 얻을 수 있다. 검사결과의 의미 있는 비교를 위해서는 추적 CT를 시행할 때 항상 같은 영상 파라미터를 사용해야 한다. 만성기관지염은 임상증상으로 진단되며 CT 소견은 비특이적이다. CT를 사용하여 기도벽 비후를 객관적으로 측정할 수 있고, 이를 통해 COPD 환자에서 병태생리의 더 깊은 이해가 가능하리라고 기대된다.

Abstract

Chronic obstructive pulmonary disease (COPD) is commonly a combination of pulmonary emphysema and chronic bronchitis. Emphysema is a pathologically defined disease that can be accurately diagnosed using CT. Furthermore, CT is useful for determination of the subtypes, extent and distribution of emphysema. Objective quantification of emphysema is feasible using CT densitometry of lung parenchyma, that can be used for selection of adequate candidates and monitoring clinical results of various therapeutic measures for severe emphysema. Imaging parameters in CT densitometry should be kept constant in follow up examination for an effective comparison of the results. Chronic bronchitis is diagnosed by symptomatic criteria with nonspecific CT findings. Airway dimensions can be objectively measured using CT, enabling further understanding of pathophysiology of COPD.

참고문헌 (45)

  1. American Thoracic Society, ". Version 1.2" (2004), American Thoracic Society
  2. National Heart, Lung, and Blood Institute, "The definition of emphysema. Report of a National Heart, Lung, and Blood Institute. Division of Lung Diseases Workshop", Am Rev Respir Dis, 통권 : 132, pp.182~185 (1985)
  3. Pratt PC, "Role of conventional chest radiography in diagnosis and exclusion of emphysema", Am J Med, 82, pp.998~1006 (1987)
  4. Kazerooni EA, "Imaging of emphysema and lung volume reduction surgery", Radiographics, 17, pp.1023~1036 (1997)
  5. Webb WR, "Radiology of obstructive pulmonary disease", AJR Am J Roentgenol, 169, pp.637~647 (1997)
  6. Thurlbeck WM, "Emphysema: definition, imaging, quantification", AJR Am J Roentgenol, 163, pp.1017~1025 (1994)
  7. Stern EJ, "CT of the lung in patients with pulmonary emphysema: diagnosis, quantification, and correlation with pathologic and physiologic findings", AJR Am J Roentgenol, 162, pp.791~798 (1994)
  8. Bergin CJ, "The diagnosis of emphysema: a computed tomographic‐pathologic correlation", Am Rev Respir Dis, 133, pp.541~546 (1986)
  9. Sashidhar K, "Emphysema in heavy smoker with normal chest radiography: detection and quantification by HRCT", Acta Radiol, 43, pp.60~65 (2002)
  10. Copley SJ, "Thin‐section CT in obstructive pulmonary disease: discretionary value", Radiology, 223, pp.812~819 (2002)
  11. Chabat F, "Obstructive lung diseases: texture classification for differentiation at CT", Radiology, 228, pp.871~877 (2003)
  12. Goddard PR, "Computed tomography in pulmonary emphysema", Clin Radiol, 33, pp.379~387 (1982)
  13. Sakai F, "Pulmonary function abnormalities in patients with CT‐determined emphysema", J Comput Assist Tomogr, 11, pp.963~968 (1987)
  14. Hayhurst MD, "Diagnosis of pulmonary emphysema by computerized tomography", Lancet, 2, pp.320~322 (1984)
  15. Müller NL, "“Density mask”: an objective method to quantitate emphysema using computed tomography", Chest, 94, pp.782~787 (1988)
  16. Kinsella M, "Quantitation of emphysema by computed tomography using a “density mask” program and correlation with pulmonary function test", Chest, 97, pp.315~321 (1990)
  17. Park KJ, "Quantification of emphysema with three‐dimensional CT densitometry: comparison with two‐dimensional analysis, visual emphysema scores, and pulmonary function test results", Radiology, 211, pp.541~547 (1999)
  18. Kemerink GJ, "Scanner conformity in CT densitometry of the lungs", Radiology, 197, pp.749~752 (1995)
  19. Adams H, "An appraisal of CT pulmonary density mapping in normal subjects", Clin Radiol, 43, pp.238~242 (1991)
  20. Lamers RJ, "Chronic obstructive pulmonary disease: evaluation with spirometrically controlled CT lung densitometry", Radiology, 193, pp.109~113 (1994)
  21. Knudson RJ, "Expiratory computed tomography for assessment of suspected pulmonary emphysema", Chest, 99, pp.1357~1366 (1991)
  22. Gierada DS, "Repeatability of quantitative CT indexes of emphysema in patients evaluated for lung volume reduction surgery", Radiology, 220, pp.448~454 (2001)
  23. Gevenois PA, "Pulmonary emphysema: quantitative CT during expiration", Radiology, 199, pp.825~829 (1996)
  24. Madani A, "Pulmonary emphysema: objective quantification at multi‐detector row CTcomparison with macroscopic and microscopic morphometry", Radiology, 238, pp.1036~1043 (2006)
  25. Madani A, "Pulmonary emphysema: radiation dose and section thickness at multidetector CT quantification‐comparison with macroscopic and microscopic morphometry", Radiology, 243, pp.250~257 (2007)
  26. 이현주, "만성폐쇄성폐질환 환자를 대상으로 흡기와 호기 시에 시행된 전산화단층촬영에서 폐기종지수를 구하기 위한 역치에 대한 연구: 폐기능검사와의 연관도에의 영향", 대한영상의학회지, 59(2), pp.99~106 (2008), 대한영상의학회
  27. Parr DG, "Influence of calibration on densitometric studies of emphysema progression using computed tomography", Am J Respir Crit Care Med, 170, pp.883~890 (2004)
  28. Newell JD Jr, "Quantitative computed tomography of lung parenchyma in chronic obstructive pulmonary disease: an overview", Proc Am Thorac Soc, 5, pp.915~918 (2008)
  29. Boedeker KL, "Emphysema: effect of reconstruction algorithm on CT imaging measures", Radiology, 232, pp.295~301 (2004)
  30. Camiciottoli G, "Spirometrically gated highresolution CT findings in COPD: lung attenuation versus lung function and dyspnea severity", Chest, 129, pp.558~564 (2006)
  31. Zaporozhan J, "Paired inspiratory", expiratory volumetric thin‐slice CT scan for emphysema analysis: comparison of different quantitative evaluations and pulmonary function test, 2005, pp.128, 3212~3220
  32. Gierada DS, "Pulmonary emphysema: comparison of preoperative quantitative CT and physiologic index values with clinical outcome after lung‐volume reduction surgery", Radiology, 205, pp.235~242 (1997)
  33. Kazerooni EA, "Radiologic evaluation of emphysema for lung volume reduction surgery", Clin Chest Med, 20, pp.845~861 (1999)
  34. Dirksen A, "A randomized clinical trial of alpha(1)‐antitrypsin augmentation therapy", Am J Respir Crit Care Med, 160, pp.1468~1472 (1999)
  35. Wu MT, "Use of quantitative CT to predict postoperative lung function in patients with lung cancer", Radiology, 191, pp.257~262 (1994)
  36. Ohno Y, "Postoperative lung function in lung cancer patients: comparative analysis of predictive capability of MRI, CT, and SPECT", AJR Am J Roentgen, 189, pp.400~408 (2007)
  37. Shaker SB, "Imaging in chronic obstructive pulmonary disease", COPD, 4, pp.143~161 (2007)
  38. Remy‐Jardin M, "Morphologic effects of cigarette smoking on airways and pulmonary parenchyma in healthy adult volunteers: CT evaluation and correlation with pulmonary function tests", Radiology, 186, pp.107~115 (1993)
  39. Nakano Y, "Computed tomographic measurements of airway dimensions and emphysema in smokers: correlation with lung function", Am J Respir Crit Care Med, 162, pp.1102~1108 (2000)
  40. King GG, "An analysis algorithm for measuring airway lumen and wall areas from high‐resolution computed tomographic data", Am J Respir Crit Care Med, 161, pp.574~580 (2000)
  41. Berger P, "Airway wall thickness in cigarette smokers: quantitative thin‐section CT assessment", Radiology, 235, pp.1055~1064 (2005)
  42. Nakano Y, "The prediction of small airway dimensions using computed tomography", Am J Respir Crit Care Med, 171, pp.142~146 (2005)
  43. Hasegawa M, "Airflow limitation and airway dimensions in chronic obstructive pulmonary disease", Am J Respir Crit Care Med, 173, pp.1309~1315 (2006)
  44. Orlandi I, "Chronic obstructive pulmonary disease: thin‐section CT measurement of airway wall thickness and lung attenuation", Radiology, 234, pp.604~610 (2005)
  45. O’Donnell RA, "Relationship between peripheral airway dysfunction, airway obstruction, and neutrophilic inflammation in COPD", Thorax, 59, pp.837~842 (2004)

관련 논문AI추천

만성기도질환에서 호기말 흉부 CT를 이용한 기관협착에 관한 연구김상훈, 백대현, 송은주, 이기덕, 이병훈, 이상렬, 이성혁, 이재형대한내과학회 · 대한내과학회지2009 · 제76권 제2호Clinical impact of long-term change in air trapping on pulmonary function and computed tomography parameters in chronic obstructive pulmonary diseaseChin Kook Rhee, Jae Seung Lee, Jeong Uk Lim, Ji-Hyun Lee, Sang-Do Lee, Yeon-Mok Oh대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제3호Usefulness Evaluation of Low-dose CT for Emphysema : Compared with High-resolution CT이원정대한방사선과학회 · Journal of Radiological Science and Technology2016 · 제39권 제3호HRCT를 이용한 천식의 중증도에 따른 기도개형의 평가김양수, 임성용, 최병휘대한내과학회 · 대한내과학회지2007 · 제73권 제6호Recent advances in airway imaging using microcomputed tomography and computed tomography for chronic obstructive pulmonary diseaseNaoya Tanabe, Toyohiro Hirai대한내과학회 · The Korean Journal of Internal Medicine2021 · 제36권 제6호만성 폐쇄성폐질환의 폐기능 검사와 운동 검사의 비교권선중, 나문준, 나운태, 박주호, 손지웅, 이고은, 최유진대한내과학회 · 대한내과학회지2009 · 제76권 제5호

이 간행물의 다른 논문 (7건)

최근 대규모 만성폐쇄성폐질환 임상연구의 해석과 적용이재승, 오연목pp. 429-434IgA 신증 40여 년임천규pp. 435-443렙토스피라병에서 폐침범의 임상적 관점김민자pp. 450-452메타콜린과 운동 유발 기관지 수축반응의 상관관계에 대한 종단적 연구우학, 한의령, 최인선, 김상훈, 심현정, 김창성pp. 472-479임신 3분기 중 발현된 요붕증한기옥, 류현미, 박소영, 김성훈, 윤현구, 이수희, 원현선pp. 512-516
원문 보기