Centrilobular emphysema: CT-pathologic correlation.

Foster, William L.; Pratt, Philip C.; Roggli, Victor L.; Godwin, J. David; Ra, Halvorsen; Putman, Charles E.

doi:10.1148/radiology.159.1.3952318

Cited by 149 publications

(74 citation statements)

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“…Centrilobular pulmonary arteries or arterioles, which are often seen traversing the hypoattenuated areas, mark the center of each lobule (9). This pattern of emphysema correlates well with pathologically demonstrated CLE (59,(66)(67)(68) and with micro-CT measurements of the primary lesions (Fig 2, B). This is the most common type of smokingrelated emphysema and is usually upper lung predominant (Figs 3, 4).…”

Section: Quantitative Ct Image Analysissupporting

confidence: 85%

CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

Lynch¹,

Austin²,

Hogg³

et al. 2015

Radiology

489

413

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Section: Quantitative Ct Image Analysissupporting

confidence: 85%

CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

Lynch¹,

Austin²,

Hogg³

et al. 2015

Radiology

489

413

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“…Impairment of transfer factor is considered the best functional indicator of the presence and severity of emphysema, being positively correlated with underlying CT changes of disease [43]. Indeed, COPD patients with emphysema did appear particularly prone to SRCs.…”

Section: Discussionmentioning

confidence: 99%

Upper abdominal surgery: does a lung function test exist to predict early severe postoperative respiratory complications?

Barisione¹,

Rovida²,

Gazzaniga³

et al. 1997

Eur Respir J

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We evaluated the capacity to predict severe respiratory complications (SRCs) following upper abdominal surgery (UAS) by using the results of a respiratory questionnaire and preoperative pulmonary function tests.Lung volumes, flows and transfer factor of the lung for carbon monoxide (TL,CO,sb) were assessed in 361 consecutive adult patients (248 males and 113 females). SRCs were diagnosed 24 h after UAS by clinical examination and chest radiography. Univariate and stepwise multiple logistic regression analyses were performed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each single input variable, and to determine which indices best predicted outcome.These patients had a 1% mortality rate and 14% incidence of SRCs, with a male:female ratio of 0.86. The best predictors for SRCs by multiple analysis were: preoperative current hypersecretion of mucus (OR=133; p<0.0001); an increase in residual volume (RV) (OR=3.11; p=0.01); and, to a lesser extent, low percentage of predicted values both of forced expiratory volume in one second (FEV1 % pred) and TL,CO,sb. The algorithm thus obtained (logit θ) was extremely sensitive (84%), specific (99%), and accurate (95%) for preoperative prediction of SRCs.We have found that preoperative current hypersecretion of mucus and pulmonary hyperinflation, and to a lesser extent percentage predicted values both of forced expiratory volume in one second and transfer factor of the lung for carbon monoxide, have a significant predictive capacity for severe respiratory complications following upper abdominal surgery. Eur Respir J 1997; 10: 1301-1308 Since 1910, it has been well-known that patients undergoing upper abdominal surgery (UAS) generally develop a severe pulmonary restrictive pattern [1], and carry a high risk of postoperative respiratory complications [2][3][4]. The most important factors determining the degree of postoperative impairment of ventilation and gas exchange are the site of operation, the age, and clinical status of the patient [5]. Forced vital capacity (FVC) and peak flows are often reduced to half, and the functional residual capacity (FRC) to below 70% of the preoperative values [5]. These effects may not be restored even by the fifth postoperative day [5]. The reduced FVC and the reduction of FRC are mainly a consequence of an impaired diaphragmatic function [6]. Furthermore, the risk for postoperative respiratory complications decreases with the distance of the surgical incision from the diaphragm [7,8].Several studies have tried to determine the incidence of postoperative respiratory complications of UAS, and the estimates vary widely. The majority of investigations have focused on subclinical complications, i.e. radiographic evidence of atelectasis, with or without pleural fluid. With this broader definition of complication, the incidence of postoperative complications of UAS is approximately 25-75% [9,10].In this paper, we examine the relationship between preoperative respiratory symptoms and physiology, and postoperative r...

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“…The radiological criteria were: well defined 1-2 mm centrilobular holes in the secondary pulmonary lobule with no discernible wall, preserved anatomical borders of the secondary pulmonary lobule, and involvement predominantly in the upper lung zones. 6 All participants were in a nonacute phase of their disease and were receiving a stable drug regimen. Participants had no coexisting medical conditions that would interfere with physiologic testing.…”

Section: Methodsmentioning

confidence: 99%

Ventilatory Inefficiency as a Limiting Factor for Exercise in Patients With COPD

Caviedes¹,

Delgado

Soto³

2012

Respir Care

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BACKGROUND: Ventilatory inefficiency increases ventilatory demand; corresponds to an abnormal increase in the ratio of minute ventilation (V E ) to CO 2 production (V CO 2 ); represents increased dead space, deregulation of respiratory control, and early lactic threshold; and is associated with expiratory flow limitation that enhances dynamic hyperinflation and may limit exercise capacity. OBJECTIVE: To evaluate the influence of ventilatory inefficiency over exercise capacity in COPD patients. METHODS: Prospective study of 35 COPD subjects with different levels of severity, in whom cardiopulmonary stress test was performed. Ventilatory inefficiency was represented by the V E /V CO 2 relation. Its influence over maximal oxygen consumption (V O 2 max), power (W), and ventilatory threshold was evaluated. Surrogate parameters of cardiac function, like oxygen pulse (V O 2 /heart rate) and circulatory power (%V O 2 max ؋ peak systolic pressure), were also evaluated. RESULTS: Cardiopulmonary stress test was stopped due to dyspnea with elevated V E and marked reduction of breathing reserve. A severe increase in V E /V CO 2 (mean ؎ SD 35.9 ؎ 5.6), a decrease of V O 2 max (mean ؎ SD 75.2 ؎ 20%), and a decrease of W (mean ؎ SD 68.6 ؎ 23.3%) were demonstrated. Twenty-eight patients presented dynamic hyperinflation. Linear regression showed a reduction of 2.04% on V O 2 max (P < .001), 2.6% on W (P < .001), 1% on V O 2 /heart rate (P ‫؍‬ .049), and 322.7 units on circulatory power (P ‫؍‬ .02) per each unit of increment in V E /V CO 2 , respectively. CONCLUSIONS: Ventilatory inefficiency correlates with a reduction in exercise capacity in COPD patients. Including this parameter in the evaluation of exercise limitation in this patient population may mean a contribution toward the understanding of its pathophysiology.

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Centrilobular emphysema: CT-pathologic correlation.

Cited by 149 publications

References 0 publications

CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society

Upper abdominal surgery: does a lung function test exist to predict early severe postoperative respiratory complications?

Ventilatory Inefficiency as a Limiting Factor for Exercise in Patients With COPD

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