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Serial Change in Airway Lumen and Wall Thickness at Thin-Section CT in Asymptomatic Subjects¹

¹ From the Department of Diagnostic Radiology, Fujisawa City Hospital, Fujisawa City, Kanagawa, Japan (S.M., H.A., K.K.); and Department of Radiology, St Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan (Y.K., Y.N., H.N.). Received September 11, 2003; revision requested November 24; final revision received March 23, 2004; accepted April 15. Address correspondence to S.M., Department of Radiology, St Marianna University School of Medicine, 2–16-1 Sugao, Miyamae-Ku, Kawasaki City, Kanagawa 216-8511, Japan (e-mail: shinma@d9.dion.ne.jp).

View larger version (111K): [in a new window]   Figure 1a. Method for measurement of airway dimensions. (a) By using transverse CT scan containing right posterior bronchus, window width was set to minimum value (2 HU) to obtain thresholding transverse CT scan, and window level of –500 HU was chosen. (b) Bronchial lumen was then displayed in black (1), and bronchial wall was white. Luminal area and short and long axes of lumen were measured automatically. (c) Continuously, bronchial lumen was changed to white by using paint tool, and then white and black were inverted (2). Bronchial outer circumference was similarly outlined automatically, and total airway area and short axis of total airway were determined on thresholding transverse CT scan.

View larger version (16K): [in a new window]   Figure 1b. Method for measurement of airway dimensions. (a) By using transverse CT scan containing right posterior bronchus, window width was set to minimum value (2 HU) to obtain thresholding transverse CT scan, and window level of –500 HU was chosen. (b) Bronchial lumen was then displayed in black (1), and bronchial wall was white. Luminal area and short and long axes of lumen were measured automatically. (c) Continuously, bronchial lumen was changed to white by using paint tool, and then white and black were inverted (2). Bronchial outer circumference was similarly outlined automatically, and total airway area and short axis of total airway were determined on thresholding transverse CT scan.

View larger version (20K): [in a new window]   Figure 1c. Method for measurement of airway dimensions. (a) By using transverse CT scan containing right posterior bronchus, window width was set to minimum value (2 HU) to obtain thresholding transverse CT scan, and window level of –500 HU was chosen. (b) Bronchial lumen was then displayed in black (1), and bronchial wall was white. Luminal area and short and long axes of lumen were measured automatically. (c) Continuously, bronchial lumen was changed to white by using paint tool, and then white and black were inverted (2). Bronchial outer circumference was similarly outlined automatically, and total airway area and short axis of total airway were determined on thresholding transverse CT scan.

View larger version (21K): [in a new window]   Figure 2a. Plots show (a) intraobserver and (b) intrerobserver error for measurement of LA. Mean of two measurements and difference between them are plotted. Mean difference did not appreciably deviate from zero, and limits of agreement were small. There was no obvious relationship between measurement error and LA.

View larger version (24K): [in a new window]   Figure 2b. Plots show (a) intraobserver and (b) intrerobserver error for measurement of LA. Mean of two measurements and difference between them are plotted. Mean difference did not appreciably deviate from zero, and limits of agreement were small. There was no obvious relationship between measurement error and LA.

View larger version (37K): [in a new window]   Figure 3a. Serial changes in (a) LA and (b) percentage LA are shown. LA and percentage LA decreased as CT proceeded from hilum to periphery (r = –0.765 and P < .001 versus r = –0.851 and P < .001). Interval of two continuous sections was 2 mm.

View larger version (38K): [in a new window]   Figure 3b. Serial changes in (a) LA and (b) percentage LA are shown. LA and percentage LA decreased as CT proceeded from hilum to periphery (r = –0.765 and P < .001 versus r = –0.851 and P < .001). Interval of two continuous sections was 2 mm.

View larger version (20K): [in a new window]   Figure 4. Histogram shows distribution of changes in LA. In 101 (10.7%) of 943 bronchi, LA increased by 10% or more. In 32.7% of sites observed in contiguous CT sections, airway lumen did not decrease on peripheral side.

View larger version (44K): [in a new window]   Figure 5a. Plots show serial changes in (a) WA% and (b) percentage WA%. WA% and percentage WA% tended to increase as CT proceeded from hilum to periphery (r = 0.393 and P < .001 versus r = 0.374 and P < .001).

View larger version (40K): [in a new window]   Figure 5b. Plots show serial changes in (a) WA% and (b) percentage WA%. WA% and percentage WA% tended to increase as CT proceeded from hilum to periphery (r = 0.393 and P < .001 versus r = 0.374 and P < .001).

View larger version (45K): [in a new window]   Figure 6a. Plots show serial changes in (a) WT/D ratio (T/D ratio) and (b) percentage WT/D ratio (Percent T/D ratio). Both WT/D ratio and percentage WT/D ratio tended to increase as CT proceeded from hilum to periphery (r = 0.367 and P < .001 versus r = 0.352 and P < .001).

View larger version (37K): [in a new window]   Figure 6b. Plots show serial changes in (a) WT/D ratio (T/D ratio) and (b) percentage WT/D ratio (Percent T/D ratio). Both WT/D ratio and percentage WT/D ratio tended to increase as CT proceeded from hilum to periphery (r = 0.367 and P < .001 versus r = 0.352 and P < .001).

View larger version (19K): [in a new window]   Figure 7a. Histogram shows distribution of changes in (a) WA% and (b) WT/D ratio (T/D ratio). In 29.0% of all measured bronchi, change in WA% between two contiguous sections was greater than 5%. In 35.8% of all measured bronchi, change in WT/D ratio between two contiguous sections was greater than 0.02.

View larger version (20K): [in a new window]   Figure 7b. Histogram shows distribution of changes in (a) WA% and (b) WT/D ratio (T/D ratio). In 29.0% of all measured bronchi, change in WA% between two contiguous sections was greater than 5%. In 35.8% of all measured bronchi, change in WT/D ratio between two contiguous sections was greater than 0.02.