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Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury
Intensive Care Medicine Experimental Pub Date : 2019-11-01 , DOI: 10.1186/s40635-019-0273-y
John N Cronin 1 , João Batista Borges 1 , Douglas C Crockett 2 , Andrew D Farmery 2 , Göran Hedenstierna 3 , Anders Larsson 4 , Minh C Tran 2 , Luigi Camporota 1, 5 , Federico Formenti 1, 2
Affiliation  

BackgroundDynamic single-slice CT (dCT) is increasingly used to examine the intra-tidal, physiological variation in aeration and lung density in experimental lung injury. The ability of dCT to predict whole-lung values is unclear, especially for dual-energy CT (DECT) variables. Additionally, the effect of inspiration-related lung movement on CT variables has not yet been quantified.MethodsEight domestic pigs were studied under general anaesthesia, including four following saline-lavage surfactant depletion (lung injury model). DECT, dCT and whole-lung images were collected at 12 ventilatory settings. Whole-lung single energy scans images were collected during expiratory and inspiratory apnoeas at positive end-expiratory pressures from 0 to 20 cmH2O. Means and distributions of CT variables were calculated for both dCT and whole-lung images. The cranio-caudal displacement of the anatomical slice was measured from whole-lung images.ResultsMean CT density and volume fractions of soft tissue, gas, iodinated blood, atelectasis, poor aeration, normal aeration and overdistension correlated between dCT and the whole lung (r2 0.75–0.94) with agreement between CT density distributions (r 0.89–0.97). Inspiration increased the matching between dCT and whole-lung values and was associated with a movement of 32% (SD 15%) of the imaged slice out of the scanner field-of-view. This effect introduced an artefactual increase in dCT mean CT density during inspiration, opposite to that caused by the underlying physiology.ConclusionsOverall, dCT closely approximates whole-lung aeration and density. This approximation is improved by inspiration where a decrease in CT density and atelectasis can be interpreted as physiological rather than artefactual.

中文翻译:

动态单层 CT 估计有和没有实验性肺损伤猪的全肺双能 CT 变量

背景动态单层 CT (dCT) 越来越多地用于检查实验性肺损伤中通气和肺密度的潮气内生理变化。dCT 预测全肺值的能力尚不清楚,尤其是双能 CT (DECT) 变量。此外,与吸气相关的肺运动对 CT 变量的影响尚未量化。方法在全身麻醉下研究了八头家猪,其中包括四头盐水灌洗表面活性剂耗竭(肺损伤模型)。DECT、dCT 和全肺图像在 12 种通气设置下收集。在 0 至 20 cmH2O 的呼气末正压下,在呼气和吸气呼吸暂停期间收集全肺单能量扫描图像。计算 dCT 和全肺图像的 CT 变量的平均值和分布。从全肺图像测量解剖切片的颅尾位移。 结果软组织、气体、碘化血、肺不张、通气不良、通气正常和过度扩张的平均 CT 密度和体积分数与 dCT 和全肺相关(r2 0.75–0.94) 与 CT 密度分布之间的一致性 (r 0.89–0.97)。吸气增加了 dCT 和全肺值之间的匹配,并且与扫描仪视野外 32% (SD 15%) 的成像切片移动相关。这种效应导致吸气期间 dCT 平均 CT 密度人为增加,这与潜在生理机能引起的相反。结论总的来说,dCT 非常接近全肺通气和密度。
更新日期:2019-11-01
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