Quantifizierung von Atelektasen bei kontrollierter Beatmung: Spiral-CT versus dynamische Einzelschicht-CT

Bletz, C.; Markstaller, Klaus; Karmrodt, J.; Herweling, Annette; Melvan, M; Goetz, Raymond R.; Stepniak, Andreas; Eberle, Balthasar; Kauczor, HU; Heußel, CP; Thelen, M.

doi:10.1055/s-2004-812889

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…Previous experiments in uninjured pigs have demonstrated that a subcarinal slice overestimates both overdistension and atelectasis and underestimates ventilated regions [9], in contrast with our results. Interestingly, the overdistended regions represented a significantly smaller fraction of the slice/lung volume in our study compared with those previously described (0.6% in dCT vs 1.2% in the whole lung as compared with 6.4% in dCT vs 3.1% in the whole lung in published results [9]). A possible reason for this discrepancy is that our study used 5 mm instead of 1-mm-thick CT slices.…”

Section: Discussioncontrasting

confidence: 99%

“…Authors of studies reporting tidal variations in parameters consistent with a decrease in CT density and atelectasis during inspiration can be reassured these are outside the limits of error introduced by the dCT technique and therefore represent true (patho)physiology. Overall, these results are confirmatory of previous findings [9, 10], extend the agreement to DECT indices and further explore the effects of inspiration with morphological analysis.…”

Section: Discussionsupporting

confidence: 91%

“…The hilar vessels and bronchi contain a large proportion of very high- and very low-density voxels, respectively, and inclusion of a small amount of these regions can dramatically affect results. Previously, it has been demonstrated that such regions comprise about 6% of lung volume segmented for dCT vs whole-lung studies [9], and thus, again, any small changes in what is chosen as comprising the segmented area or not would lead to large discrepancies between reported volumes in different studies.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated these issues. In healthy pigs, a single dCT slice 3 cm caudal to the carina overestimated atelectatic volume within the lung by 28.4% compared with 19.0% in whole lung volume scans taken during inspiratory apnoeas [9]. Following induction of a lung injury model, dCT slices in expiration or inspiration showed distributions of CT densities similar to the same regions imaged during breath holds at end-expiration or end-inspiration, respectively [10].…”

Section: Introductionmentioning

confidence: 99%

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Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury

Cronin

Borges

Crockett

et al. 2019

ICMx

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BackgroundDynamic single-slice CT (dCT) is increasingly used to examine the intra-tidal, physiological variation in aeration and lung density in experimental lung injury. The ability of dCT to predict whole-lung values is unclear, especially for dual-energy CT (DECT) variables. Additionally, the effect of inspiration-related lung movement on CT variables has not yet been quantified.MethodsEight domestic pigs were studied under general anaesthesia, including four following saline-lavage surfactant depletion (lung injury model). DECT, dCT and whole-lung images were collected at 12 ventilatory settings. Whole-lung single energy scans images were collected during expiratory and inspiratory apnoeas at positive end-expiratory pressures from 0 to 20 cmH2O. Means and distributions of CT variables were calculated for both dCT and whole-lung images. The cranio-caudal displacement of the anatomical slice was measured from whole-lung images.ResultsMean CT density and volume fractions of soft tissue, gas, iodinated blood, atelectasis, poor aeration, normal aeration and overdistension correlated between dCT and the whole lung (r2 0.75–0.94) with agreement between CT density distributions (r 0.89–0.97). Inspiration increased the matching between dCT and whole-lung values and was associated with a movement of 32% (SD 15%) of the imaged slice out of the scanner field-of-view. This effect introduced an artefactual increase in dCT mean CT density during inspiration, opposite to that caused by the underlying physiology.ConclusionsOverall, dCT closely approximates whole-lung aeration and density. This approximation is improved by inspiration where a decrease in CT density and atelectasis can be interpreted as physiological rather than artefactual.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury

Cronin

Borges

Crockett

et al. 2019

ICMx

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Funktionelle MRT der Lunge unter Verwendung von hyperpolarisiertem 3Helium-Gas

Gast

Morbach²,

Kauczor

et al. 2005

Med Klin

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Lung imaging is traditionally done using X-ray-based methods, since MRI is limited by low proton density as well as inherent magnetic field inhomogeneities of the lung tissue. After introduction of MRI using hyperpolarized noble gases, a totally new field of MRI of the chest has rapidly evolved. These techniques reveal new functional information of the lungs, which could not be obtained before. The first part of this review describes the underlying MR technology explaining distribution of static ventilation, dynamic distribution of ventilation, lung microstructure (apparent diffusion coefficient [ADC]), measurement of oxygen partial pressure (pO(2)), and safety. The clinical potential is afterwards demonstrated in the second part. Therefore, the effort in normal lungs and the mainly focused diseases chronic obstructive pulmonary disease (COPD), smoker's lung, cystic fibrosis, asthma, lung transplantation, and pulmonary embolism are reported.

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Multislice spiral computed tomography to determine the effects of a recruitment maneuver in experimental lung injury

et al. 2005

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Although recruitment of atelectatic lung is a common aim in acute respiratory distress syndrome (ARDS), the effects of a recruitment maneuver have not been assessed quantitatively. By multislice spiral CT (MSCT), we analyzed the changes in lung volumes calculated from the changes in the CT values of hyperinflated (V(HYP)), normally (V(NORM)), poorly (V(POOR)) and nonaerated (V(NON)) lung in eight mechanically ventilated pigs with saline lavage-induced acute lung injury before and after a recruitment maneuver. This was compared to single slice analysis near the diaphragm. The increase in aerated lung was mainly for V(POOR) and the less in V(NORM). Total lung volume and intrathoracic gas increased. No differences were found for tidal volumes measured by spirometry or determined by CT. The inspiratory-expiratory volume differences were not different after the recruitment maneuver in V(NON) (from 62+/-18 ml to 43+/-26 ml, P = 0.114), and in V(NORM) (from 216+/-51 ml to 251+/-37 ml, P = 0.102). Single slice analysis significantly underestimated the increase in normally and poorly aerated lung. Quantitative analysis of lung volumes by whole lung MSCT revealed the increase of poorly aerated lung as the main mechanism of a standard recruitment maneuver. MSCT can provide additional information as compared to single slice CT.

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Quantifizierung von Atelektasen bei kontrollierter Beatmung: Spiral-CT versus dynamische Einzelschicht-CT

Cited by 10 publications

References 19 publications

Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury

Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury

Funktionelle MRT der Lunge unter Verwendung von hyperpolarisiertem 3Helium-Gas

Multislice spiral computed tomography to determine the effects of a recruitment maneuver in experimental lung injury

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