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Published ahead of print on October 29, 2004, doi:10.1164/rccm.200407-874OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 2, January 2005, 142-146

A more recent version of this article appeared on January 15, 2005
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Submitted on July 7, 2004
Accepted on October 25, 2004

The Prediction of Small Airway Dimensions Using Computed Tomography

Yasutaka Nakano1, Jonathan C Wong2, Pim A de Jong2, Lilliana Buzatu2, Taishi Nagao2, Harvey O Coxson3, W Mark Elliott2, James C Hogg2, and Peter D Pare2*

1 Department of Respiratory Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan; James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada, 2 James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada, 3 James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, University of British Columbia, St. Paul's Hospital, Vancouver, British Columbia, Canada; Department of Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada

* To whom correspondence should be addressed. E-mail: ppare{at}mrl.ubc.ca.

Chronic obstructive pulmonary disease is characterized by destruction of the lung parenchyma and/or small airway narrowing. To determine if the dimensions of relatively large airways assessed using computed tomography (CT) reflect small airway dimensions measured histologically we assessed these variables in non-obstructed, or mild-moderately obstructed patients having lobar resection for a peripheral tumour. For both CT and histology the square-root of the airway wall area was plotted versus lumen perimeter to estimate wall thickness. Wall area percent was calculated as wall area / lumen area + wall area X 100. Although CT overestimated airway wall area, the slopes of the relationships between the square-root of airway wall area and internal perimeter measured with both techniques were related (CT slope = 0.2059 histology slope + 0.1701, R2=0.32, P < 0.01). The mean wall area percent measured by CT for airways with an internal perimeter > 0.75cm predicted the mean dimensions of the small airways with an internal diameter of 1.27mm (R2=0.57, p < 0.01). We conclude that CT measurements of airways with an internal perimeter ≥0.75cm could be used to estimate the dimensions of the small conducting airways, which are the site of airway obstruction in chronic obstructive pulmonary disease.
Key words: emphysema, small airways, COPD, bronchioles, bronchiolitis




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