Correlation of pulmonary function indexes determined by low-dose MDCT with spirometric pulmonary function tests in patients with chronic obstructive pulmonary disease.

OBJECTIVE: The objective of our study was to evaluate the correlation between pulmonary function indexes determined by low-dose MDCT and those obtained from routine spirometric pulmonary function tests (PFTs) in patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: Lung function of patients with COPD stages 0-III was evaluated by both MDCT and spirometric PFTs. Scanning was performed at maximum end-inspiration and maximum end-expiration. RESULTS: A very strong correlation was found between extrapolated expiratory lung volume (LVex) and COPD stage (r = 0.802, p < 0.001) and between extrapolated LVex and the ratio of forced expiratory volume in 1 second and percentage forced vital capacity (FEV1/FVC%) (r = -0.831, p < 0.001). Moreover, strong positive correlations were found between inspiratory lung volume (LVin) and total lung capacity (TLC) (r = 0.658, p < 0.001), LVex and residual volume (RV) (r = 0.683, p < 0.001), extrapolated LVex and RV (r = 0.640, p < 0.001), LVex and RV/TLC (r = 0.602, p < 0.001), LVex/LVin and RV/TLC (r = 0.622, p < 0.001), extrapolated LVex and RV/TLC (r = 0.663, p < 0.001), and LVex and COPD stage (r = 0.697, p < 0.001). CONCLUSION: Low-dose MDCT lung function indexes correlate well with spirometric PFT results, and the highest correlation is at end-expiration. Low-dose MDCT may be useful for evaluating lung function in patients with COPD.

Pulmonary mucosa-associated lymphoid tissue lymphoma: computed tomography and ¹8F fluorodeoxyglucose-positron emission tomography/computed tomography imaging findings and follow-up.

PURPOSE: The aim of the study was to present the computed tomography (CT) and fluorine 18 (F) fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT imaging findings of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma and evaluate their roles in the follow-up of this tumor. METHODS: Computed tomography and FDG-PET/CT imaging findings of 18 cases of pathologically proven pulmonary MALT lymphoma were reviewed retrospectively. RESULTS: Multiple and solitary lesions were detected in 15 and 3 patients, respectively. Of those patients with multiple pulmonary lesions, 12 were bilateral, and 3 were unilateral. A total of 51 pulmonary lesions were identified in 18 patients, which included lesions with consolidation (31/51), mass and nodule (12/51), and ground-glass attenuation (8/51). F fluorodeoxyglucose-PET/CT imaging (n = 8) revealed increased FDG uptake in all lesions in 8 cases. At follow-up, 3 patients experienced complete remission, 10 had partial remission, and 2 remained stable. CONCLUSIONS: Computed tomography and FDG-PET/CT images of the pulmonary MALT lymphoma usually reveal multiple, bilateral consolidations, masses, or nodules with air bronchogram and increased FDG uptake. Computed tomography and FDG-PET/CT imaging play important roles in the diagnosis and follow-up of patients with pulmonary MALT lymphoma.

[Evaluation of correlation between pulmonary function testing and high resolution computed tomography in pulmonary alveolar proteinosis].

OBJECTIVE: Pulmonary alveolar proteinosis (PAP) is a rare respiratory disorder featured by lipoproteinaceous material accumulation within alveoli. Pulmonary function testing (PFT) and quantitative high resolution computed tomography (HRCT) are used in evaluation of the severity, development and treatment effects of PAP. METHODS: Seventeen patients (10 males, 7 females), aged from 15 to 51 years old, with PAP histopathologically proven by positive periodic acid Schiff reaction were studied in our institute from 2004 to 2007. PFTs and HRCT were performed in all patients. The quantitative parameters of HRCT included total lung volume (TLV), total lung mass (TLM), air-filling lung volume (AFLV), averaged lung density (ALD) and the ratio of air-filling lung volume to total lung volume (AFLV/TLV). The parameters of PFT included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, diffusion capacity of carbon monoxide (D(L)CO), the ratio of D(L)CO to alveolar volume (D(L)CO/V(A)), total lung capacity (TLC), residual volume (RV), RV/TLC. A total of 24 dataset of the PFT and HRCT were collected. The correlation and regression between PFTs and HRCT were analyzed. PFT and HRCT parameters were compared before and after treatment with whole lung lavage in 6 of these patients. The data were expressed with mean +/- standard deviation and analyzed with SPSS 13.0 software. RESULTS: Restrictive ventilation function disorder and diffusion function disorder were found in patients with PAP, with more significant decline in D(L)CO (46.1% of predicted and abnormal rate 94.1%). Correlation between PFTs and HRCT parameters were found, with significance in ALD and FVC (r = -0.469, P = 0.021), TLM and FEV1 (r= -0.482, P = 0.017), AFLV/TLV and PEF (r = 0.511, P = 0.011), D(L)CO and D(L)CO/V(A) (r = 0.659, 0.692, P = 0.000, respectively). The highest correlation was found between D(L)CO/V(A) and AFLV (r = 0.525; P < 0.05). D(L)CO was markedly improved after the treatment of whole lung lavage, simultaneously found with varied improvement of quantitative parameters of HRCT measurements. CONCLUSIONS: Pulmonary function was impaired and correlated with abnormal appearance in HRCT in patients with PAP. Quantitative HRCT may be helpful in prediction of pulmonary function changes. Both techniques are important for the prognosis, outcome and follow-up studies of the disease.

[Analysis of the imaging findings of pulmonary alveolar proteinosis].

OBJECTIVE: To analyze the chest X-ray and CT findings of pulmonary alveolar proteinosis (PAP) in an effort to improve the accuracy of diagnosis. METHODS: The imaging findings by chest X-ray and CT of 6 proven PAP cases (by imaging examinations, autopsy and bronchoalveolar lavage) were retrospectively analyzed on the basis of literature review. RESULTS: Chest X-ray and CT presented diffuse small nodules in both lungs in the 6 cases, also showing scattered small or large patches of ground-glass opacity (GGO) along with consolidation in the lungs. CT also showed reticular shadows (creating typical crazy-paving appearance) and signs of bronchial air in the patches of GGO. CONCLUSIONS: X-ray film can find the pulmonary lesions but is usually unable to establish a definite diagnosis. Chest CT is capable of revealing the extent, delineation and characteristic manifestations of PAP, which helps to derive a definite diagnosis in combination with a thorough review of the patients' clinical history.

[Diagnosis of thyroid carcinoma by magnetic resonance imaging (MRI)].

BACKGROUND & OBJECTIVE: Magnetic resonance imaging (MRI) has been demonstrated to be important for the evaluation of thyroid diseases. Several foreign authors have reported MRI manifestation of thyroid carcinoma; however, there were few reports about this in China. This study was designed to investigate the diagnostic value of MRI in thyroid carcinoma by comparing MRI manifestation with histopathological features of thyroid carcinoma. METHODS: Thirty-one cases of thyroid carcinoma were analyzed retrospectively with preoperational MRI and postoperational pathological findings. RESULTS: Among 31 cases of thyroid carcinoma, 20 cases showed heterogeneous intensity in MRI and liquefied or hemorrhagic or cystic degeneration at histopathological examination. Twenty-two cases showed ill defined. Twenty-two cases showed irregular shapes, of 10 cases showed "the discontinuous capsule-like sign with low signal intensity around the tumor" in MRI and that pseudocapsules have been penetrated and partially destroyed by tumors in histopathological findings. Nineteen cases showed the tumors infiltrated the adjacent structures. Nineteen cases showed metastatic lymphadenopathy on the neck. CONCLUSION: "The discontinuous capsule-like sign with low signal intensity around the tumor" is the characteristic manifestation of thyroid carcinoma on MRI. Heterogeneous signal, obscure margin, and irregular shape are the important features for diagnosis of thyroid carcinoma. MRI can demonstrate small lesions, provide the precise morphologic characteristics of lesions, and accurately define the local extension of tumors.

[Relationship between computed tomography (CT) manifestations and pathology in thyroid carcinoma].

BACKGROUND & OBJECTIVE: In clinical diagnosis and treatment of thyroid carcinoma, the misdiagnosis rate is about 40%-70%and the recurrence is about 30%. This study was designed to investigate the relationship between the CT features of thyroid carcinoma and its clinical pathology. METHODS: Fourty-six cases of thyroid carcinoma, pathologically proven, were retrospectively analyzed for CT and histological findings. RESULTS: Of 46 patients with thyroid carcinoma, 31 cases showed heterogeneous density, 30 cases showed irregular shape, 37 cases showed untidy margin, 16 cases showed peninsular tubercles around the tumor,and 10 cases showed no complete enhanced ring around the tumor. 20 cases were detected calcifications, including 9 cases fine globular calcifications, 4 cases nodular calcifications, 7 cases mixture calcifications. In addition,"calcified nodule in cyst sign" were found in 7 cases. 23 cases infiltrated the adjacent structures and 15 cases were revealed metastatic lymphadenopathy on the neck. CONCLUSION: Some cases of thyroid carcinoma can be diagnosed correctly according to the characteristic manifestations on CT. Different pathological types of thyroid carcinoma were related to calcification manifestations and adjacent structure invasion. CT scan can provide reliable information in selecting therapeutic methods.