Morphological Disease Progression of Combined Pulmonary Fibrosis and Emphysema. Issue 2 (March 2015)

• Record Type: Journal Article
• Authors: Matsuoka, Shin; Yamashiro, Tsuneo; Matsushita, Shoichiro; Fujikawa, Atsuko; Kotoku, Akiyuki; Yagihashi, Kunihiro; Kurihara, Yasuyuki; Nakajima, Yasuo
• Is Part Of: Journal of computer assisted tomography. Volume 39:Issue 2(2015)
• Publication Date: 2015-03
• Subjects: Tomography -- Periodicals; Tomography -- Periodicals; Tomography; Periodicals; 616.0757
• DOI: 10.1097/RCT.0000000000000184
• Languages: English
• ISSNs: 0363-8715

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objectives</title> <p>The purpose of this study was to evaluate the differences in 5-year morphological changes among the patients with combined pulmonary fibrosis and emphysema (CPFE), emphysema alone, and fibrosis alone using quantitative computed tomography evaluation.</p> </sec> <sec> <title>Methods</title> <p>This study involved 42 patients with CPFE, 45 patients with emphysema alone, and 35 patients with fibrosis alone who underwent computed tomography scans twice (initial and 5 years after the initial scan). The extent of emphysematous lesions was obtained by calculating the percentage of low attenuation area (%LAA) lower than −950 Hounsfield units. Fibrotic lesion was defined as a high attenuation area (HAA) using thresholds with pixels between 0 and −700 Hounsfield units, and the extent of fibrosis was obtained by calculating the mean percentage of HAA (%HAA). For the quantitative evaluation of the total area of emphysematous change and fibrosis, the percentage of destructed lung area (%DA) was obtained by summing %LAA and %HAA. The 5-year changes of %LAA, %HAA, and %DA were calculated. Differences were evaluated by 1-way analysis of variance, which was followed by the Tukey-Kramer test.</p> </sec> <sec> <title>Results</title> <p>The mean change of %LAA was significantly higher in CPFE (7.4% ± 3.8%) than in emphysema alone (<italic>P</italic> < 0.05). The mean change of %DA was significantly higher in CPFE (12.9% ± 5.8%) than in emphysema alone (4.9% ± 2.8%) and fibrosis alone (7.1% ± 5.7%).</p> </sec> <sec> <title>Conclusions</title> <p>Morphological disease progression in CPFE differed from that in emphysema alone or fibrosis alone. In particular, the increase in emphysematous low-attenuation lesions was significantly higher in CPFE.</p> </sec> </abstract>