Lung imaging in COPD and asthma

IF 2.4 Q2 RESPIRATORY SYSTEM
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Abstract

Chronic obstructive pulmonary disease (COPD) and asthma are common lung diseases with heterogeneous clinical presentations. Lung imaging allows evaluations of underlying pathophysiological changes and provides additional personalized approaches for disease management. This narrative review provides an overview of recent advances in chest imaging analysis using various modalities, such as computed tomography (CT), dynamic chest radiography, and magnetic resonance imaging (MRI). Visual CT assessment localizes emphysema subtypes and mucus plugging in the airways. Dedicated software quantifies the severity and spatial distribution of emphysema and the airway tree structure, including the central airway wall thickness, branch count and fractal dimension of the tree, and airway-to-lung size ratio. Nonrigid registration of inspiratory and expiratory CT scans quantifies small airway dysfunction, local volume changes and shape deformations in specific regions. Lung ventilation and diaphragm movement are also evaluated on dynamic chest radiography. Functional MRI detects regional oxygen transfer across the alveolus using inhaled oxygen and ventilation defects and gas diffusion into the alveolar–capillary barrier tissue and red blood cells using inhaled hyperpolarized 129Xe gas. These methods have the potential to determine local functional properties in the lungs that cannot be detected by lung function tests in patients with COPD and asthma. Further studies are needed to apply these technologies in clinical practice, particularly for early disease detection and tailor-made interventions, such as the efficient selection of patients likely to respond to biologics. Moreover, research should focus on the extension of healthy life expectancy in patients at higher risk and with established diseases.

慢性阻塞性肺病和哮喘的肺部成像
慢性阻塞性肺疾病(COPD)和哮喘是常见的肺部疾病,临床表现各不相同。肺部成像可评估潜在的病理生理变化,并为疾病管理提供更多个性化方法。本综述概述了使用计算机断层扫描 (CT)、动态胸部放射摄影和磁共振成像 (MRI) 等各种模式进行胸部成像分析的最新进展。CT 可视化评估可定位肺气肿亚型和气道粘液堵塞。专用软件可量化肺气肿的严重程度和空间分布以及气道树结构,包括中心气道壁厚度、气道树的分支数量和分形维度以及气道与肺的大小比。吸气和呼气 CT 扫描的非刚性配准可量化特定区域的小气道功能障碍、局部容积变化和形状变形。肺通气和横膈膜运动也可通过动态胸片进行评估。功能磁共振成像利用吸入的氧气和通气缺陷检测肺泡内的区域氧气传输,并利用吸入的超极化 129Xe 气体检测气体扩散到肺泡-毛细血管屏障组织和红细胞的情况。这些方法有可能确定慢性阻塞性肺病和哮喘患者肺功能测试无法检测到的肺部局部功能特性。将这些技术应用于临床实践还需要进一步研究,特别是用于早期疾病检测和定制干预,如有效选择可能对生物制剂有反应的患者。此外,研究重点应放在延长高危患者和已确诊疾病患者的健康寿命上。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Respiratory investigation
Respiratory investigation RESPIRATORY SYSTEM-
CiteScore
4.90
自引率
6.50%
发文量
114
审稿时长
64 days
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