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タイトル: | Clinical impact of high-attenuation and cystic areas on computed tomography in fibrotic idiopathic interstitial pneumonias |
著者: | Tanizawa, Kiminobu https://orcid.org/0000-0002-5719-0744 (unconfirmed) Handa, Tomohiro Nagai, Sonoko Hirai, Toyohiro Kubo, Takeshi Oguma, Tsuyoshi Ito, Isao https://orcid.org/0000-0003-3109-898X (unconfirmed) Ito, Yutaka Watanabe, Kizuku Aihara, Kensaku Ikezoe, Kohei https://orcid.org/0000-0003-1097-2084 (unconfirmed) Oga, Toru Chin, Kazuo Izumi, Takateru Mishima, Michiaki |
著者名の別形: | 谷澤, 公伸 半田, 知宏 平井, 豊博 久保, 武 伊藤, 功朗 小賀, 徹 陳, 和夫 三嶋, 理晃 |
キーワード: | Quantitative computed tomography Densitometry Idiopathic interstitial pneumonias Prognosis |
発行日: | 24-Jul-2015 |
出版者: | BioMed Central Ltd. |
誌名: | BMC Pulmonary Medicine |
巻: | 15 |
論文番号: | 74 |
抄録: | Background: Quantitative computed tomography (CT) analysis has been proposed as a means of objectively assessing fibrotic interstitial pneumonia (IP) including idiopathic pulmonary fibrosis (IPF). We investigated whether percentages of high-attenuation areas (HAA%) and cystic areas (CA%) quantified from CT images were useful as indices of fibrotic IP. Methods: CT images of 74 patients with fibrotic idiopathic interstitial pneumonias (IPF, 36; non-specific interstitial pneumonia, 9; unclassifiable idiopathic interstitial pneumonia, 29) were analyzed via in-house computer software, which automatically calculated HAA%, CA%, mean lung density (MLD), standard deviation of lung density (SD-LD), kurtosis, and skewness from CT attenuation histograms. These indices were compared in each instance with physiologic measures, visual fibrosis score, clinical diagnosis, radiologic CT pattern, and prognosis. Results: HAA% correlated significantly with physiologic measures and visual fibrosis score to a moderate extent (%forced vital capacity, r<inf>s</inf> = -0.59; % carbon monoxide diffusion capacity, r<inf>s</inf> = -0.43; fibrosis score, r<inf>s</inf> = 0.23). Densitometric parameters (MLD, SD-LD, kurtosis, and skewness) correlated significantly with physiologic measures and fibrosis score (|r<inf>s</inf>| = 0.28-0.59). CA% showed no association with pulmonary functions but differed significantly between IPF and other interstitial pneumonias (IPs) (1.50 ± 2.41 % vs. 0.41 ± 0.80 %; P < 0.01) and between the definite usual interstitial pneumonia (UIP) pattern and other patterns (1.48 ± 2.38 % vs. 0.55 ± 1.19 %; P < 0.01). On univariate analysis, HAA%, MLD, SD-LD, kurtosis, skewness, fibrosis score, and definite UIP pattern all correlated with survival, with kurtosis alone identified as a significant predictor of mortality on multivariate analysis (hazard ratio = 0.67; 95 % CI, 0.44-0.96; P = 0.03). Conclusion: CA% and HAA% are novel quantitative CT indices with differing properties in fibrotic IP evaluations. HAA% largely reflects physiologic impairments, whereas CA% corresponds with diagnosis and HRCT pattern. Of the CT indices examined, kurtosis constituted the strongest predictor of mortality. |
著作権等: | © 2015 Tanizawa et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
URI: | http://hdl.handle.net/2433/212527 |
DOI(出版社版): | 10.1186/s12890-015-0069-0 |
PubMed ID: | 26202767 |
出現コレクション: | 学術雑誌掲載論文等 |
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