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Objective: multi-slice CT (MSCT) in 42 patients with chronic obstructive pulmonary disease (COPD) patients inspiratory and expiratory whole lung scan, explore the COPD patients in MSCT inspiratory and expiratory phase bronchial lumen size measurement methods; explore MSCT COPD patients inspiratory and expiratory phases 3-5 grade bronchial lumen size correlation with lung function and clinical significance. Materials and Methods: collected in our hospital from July 2009 to March 2010 42 cases of patients with COPD, these 42 cases of patients with COPD MSCT full inspiratory and expiratory lung scan, the scan parameters: voltage 120KV, current 125mA, quasi- Straight 16 × 0.75mm, pitch 0.938, slice thickness 1mm, spacing 0.5mm, matrix 512X512, vision 350, high-resolution reconstruction algorithm. Workstations (MXV Philips), window width 1000HU, window level-400HU. While pulmonary function (PFT) examination, PFT parameters measured include: forced expiratory volume in 1 second representing the percentage of the predicted value (FEV1%), forced expiratory volume in one second forced expiratory vital capacity occupancy percentage (FEV1/FVC %) that detects when the patient sitting. In this study, the bronchial lumen size measured using self program (airway analysis) completed and hollow plastic model using the simulation program for the reliability of self validation. Select the right tip segmental bronchus (RB1) and right Yehou Ji bottom segment bronchus (RB10) for the study of bronchial imaging using multi-planar reconstruction (MPR), selection and perpendicular to the longitudinal axis of the bronchial airway cross-section as the research object, with self programming (airway analysis) were measured inspiratory and expiratory phase MSCT on RB1, RB10 from three to five bronchial bronchial lumen size, each bronchus on CT in the inspiratory phase expressed by IAx-By (inspiratory airway IA, x represents the first stage of bronchial 3,4,5, y represents lung segment), expiratory CT with EAx-By (expiratory airway EA) that the use of surface area to normalize (mm2/m2), then calculate Each level of bronchial inspiratory and expiratory total average (with IAx, EAx representation), and breathe in the lumen size change: each level of each bronchus with EAx-By/IAx-By said then calculate The average ratio for each level of bronchial (EAx / IAx), using Spearman correlation analysis, analysis of all levels of the airway lumen size and breathe in lumen size change rate associated with lung function. Results: ① inspiratory phase CT, IA5 and pulmonary function measurements were correlated (IA5: rFEV1% = 0.352, pFEV1% = 0.022; rFEV1/FVC = 0.347, pFEV1/FVC = 0.024), IA3, IA4 and lung function measurements was no significant correlation. ② CT expiratory airway lumen size and pulmonary function inspiratory phase correlation coefficient is higher than CT, and the correlation coefficient is larger as the size of the airway lumen becomes smaller increase (EA3: rFEv1% = 0.192, pFEV1% = 0.224; rFEV1/FVC = 0.155, pFEV1/FVC = 0.326, EA4: rFEV1% = 0.546, pFEV1% lt; 0.001; rFEV1/FVC = 0.536, pFEV1/FVC lt; 0.001, EA5: rFEV1% = 0.725, pFEV1% <0.001; rFEV1/FVC = 0.711, pFEV1/FVC lt; 0.001). ③ EA-B10 lung airway lumen size with correlation coefficients higher than EA-B1. ④ EA4/IA4, EA5/IA5 lung function measurements with high correlation coefficient (EA4/IA4: rFEV1% = 0.542, pFEV1% lt; 0.001; rFEV1/FVC = 0.416, pFEV1/FVC = 0.006 EA5/IA5: rFEV1% / = 0.672, pFEV1% lt; 0.001; rFEV1/FVC = 0.596, pFEV1/FVC <0.001), EA3/IA3 with no significant correlation between lung function and the EA / IA and pulmonary function correlation coefficient with the size of the airway lumen becomes smaller increases. Conclusion: MSCT inspiratory and expiratory phase bronchial lumen bronchial lumen size, and breathe in the rate of change associated with lung function studies can initially get the following conclusions: 1: duplex scanning combined MSCT inhale exhale supporting software evaluation airway is feasible; 2: MSCT inspiratory and expiratory phase distal airway lumen size effect on airflow limitation than proximal airway; 3: Lower airway disease by the airflow greater than the upper limit of the contribution of the lung; 4: MSCT expiratory and inspiratory breath lumen size lumen size change rate reflects airway narrowing caused by anatomical abnormalities, including not only fixed stenosis, also includes increased luminal collapse caused dynamic stenosis, better reflect the real situation expiratory airflow limitation.
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