To objectively reappraise the role of the chest radiograph (CXR) in the clinical assessment of emphysema, we compared a standardized reading of CXR with both a visual scoring and a quantitative analysis of high resolution computed tomography (HRCT) of the chest in 46 consecutive patients with chronic obstructive pulmonary disease (COPD) and fixed expiratory airflow limitation. CXR were scored for signs of overinflation and pulmonary vascular deficiency by three independent observers. HRCT scans were independently scored for extent of emphysema and for both severity and extent of emphysema. In 28 of 46 patients, inspiratory and expiratory HRCT scans were analyzed quantitatively by measuring the mean CT number in Hounsfield Units (HU) and the percentage of lung area with CT numbers < -900 HU. Quantitative CT data were compared with reference values obtained in seven normal nonsmokers. The CXR score of emphysema showed a highly significant interobserver reproducibility and correlated linearly (p < 0.001) with HRCT visual scores and quantitative data from both inspiratory and expiratory CT scan. CXR score correlated with functional indices of airflow obstruction, overinflation, and impaired lung diffusing capacity in a way comparable to that obtained by using qualitative and quantitative CT data. Patients with no signs of emphysema on CXR had mean expiratory CT numbers within normal range and a fraction of lung area with CT numbers < -900 HU on expiratory scan not exceeding 15% of total cross-sectional area. The latter value was consistently greater than 15% in patients with CXR score > 0.(ABSTRACT TRUNCATED AT 250 WORDS)

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In 7 conscious dogs, left ventricular diastolic volume (V) was estimated by taking biplane cineradiographs with the left ventricular cavity previously outlined by permanent radiopaque markers. Left ventricular pressure (P) was measured with an implanted miniature transducer. There were two rapid filling periods during early and late diastole; little filling occurred during the middle third of diastole (diastasis). The diastolic pressure-volume relationship was approximately exponential and was fitted by the equation P = -a + be cY , where a, b, and c are positive constants; the relationship appeared to be determined principally by the elastic properties. The effects of infusions of saline, isoproterenol, calcium gluconate, and methoxamine suggested that viscous and inertial properties are also important determinants of diastolic left ventricular mechanics. No significant series viscosity was observed. Plastic properties were not detected. The elastic properties were not affected by agents having a positive inotropic effect. End-diastolic pressure often differed from that predicted by the exponential equation above, suggesting that it is not a reliable index of enddiastolic volume and left ventricular compliance. ADDITIONAL KEY WORDStantalum markers biplane cineradiography end-diastolic pressure left ventricular compliance isoproterenol elastic components myocardial plasticity series viscous element inertial properties left ventricular distensibility calcium methoxamine• The present study was undertaken to answer the following questions in the conscious dogs: (a) how does the volume of the left ventricle change during diastole; (b) what is the relationship between left ventric-