Quantitative CT analysis before and after bronchoaiveolar lavage in patients with pulmonary alveolar proteinosis
GUAN Yu-bao~1 ZENG Qing-si~1 CHEN Qiao-li~2 DENG Yu~1 WU Xiao mei~1 LI Shi-yue~2 ZHENG Jin-ping~(2*)ZHONG Nan shan~2 ( 1.Department of Radiology,the First Affiliated Hospital,Guangzhou Medical college,Guangzhou 510120,China; 2.Guangzhou Institute of Respiratory Diseases,Guangzhou 510120,China)
Objective To evaluate the clinical value of quantitative CT findings before and after bronehoalveolar lavage with pulmonary alveolar proteinosis.Methods Ten patients with pulmonary alveolar proteinosis had underwent the total 14 lavages(13 both-lung lavages and 1 single-lung lavage),were analyzed for quantitative CT findings before and after bron- choalveolar lavage.Quantitative CT analysis can obtain some information such as the total lung volume,airspace volume, lung weight,mean lung density and mean lung volume.Routine CT features can obtain some changes of lesions,including density,degree and extent.Pulmonary function test were examined in 8 patients(9 examinations).Blood gas analysis were examined in all patients.Results There were no changes in CT-measured total lung volume and airspace volume,but there were reductions from(1594±436)g to(1294±374)g in lung weight(P=0.000),mean lung density from (0.5269±0.12)g/mlto(0.4389±0.09)g/ml(P=0.006)and mean lung volume from(1.0989±0.5031)ml/g to (1.4700±0.4548)ml/g(P=0.008)following lavage.Total lung volume was correlated with the airspace volume before and after bronchoalveolar lavage(R~2=0.94,P=0.000).79% lavages on routine CT showed improvements in following lavage during short-term.9 examinations showed improvements from 45.85% 22.09% to 54.64% 19.09% in percentage of predicted diffusion capacity(DLCO%)of the lung for carbon monoxide(P=0.007)and from 67.30%±22.62% to 76.03%±18.60% in percentage of predicted diffusion constant(DLCO/VA)(P=0.03),Although FVC%,FEV1%, FEV1/FVC,PEF% have some improvements,the differences were not significant(P0.05).Following lavage,the mean values of PaO_2 improved from(8.07±2.10)kPa to(14.7±5.24)kPa(P=0.001).Conclusion Quantitative CT can ob- jectively track the changes in lung weight,mean lung volume and mean lung density.Routine CT features has a preliminary evaluation from before to after lavage of PAP.79% lavages showed improvements in following lavage during short-term.
【CateGory Index】： R563.9
【CateGory Index】： R563.9