만성폐쇄성폐질환 환자에서 정량적 CT 분석: 임상 증상과 폐기능 검사소견이 일치하는 환자군과 일치하지 않는 환자군의 비교 연구 = Quantitative CT Assessment in Chronic Obstructive Pulmonary Disease Patients: Comparison of the Patients with and without Consistent Clinical Symptoms and Pulmonary Function Results

다국어 초록 (Multilingual Abstract)

Purpose: We compared the clinical and quantitative CT measurement parameters between chronic obstructive pulmonary disease (COPD) patients with and without consistent clinical symptoms and pulmonary function results.
Materials and Methods: This study included 60 patients having a clinical diagnosis of COPD, who underwent chest CT scan and pulmonary function tests. These 60 patients were classified into typical and atypical groups, which were further sub-classified into 4 groups, based on their dyspnea score and the result of pulmonary function tests [typical 1: mild dyspnea and pulmonary function impairment (PFI); typical 2: severe dyspnea and PFI; atypical 1: mild dyspnea and severe PFI; atypical 2: severe dyspnea and mild PFI]. Quantitative measurements of the CT data for emphysema, bronchial wall thickness and air-trapping were performed using software analysis. Comparative statistical analysis was performed between the groups.
Results: The CT emphysema index correlated well with the results of the pulmonary functional test (typical 1 vs. atypical 1, p = 0.032), and the bronchial wall area ratio correlated with the dyspnea score (typical 1 vs. atypical 2, p = 0.033). CT air-trapping index also correlated with the results of the pulmonary function test (typical 1 vs. atypical 1, p = 0.012) and dyspnea score (typical 1 vs. atypical 2, p = 0.000), and was found to be the most significant parameter between the typical and atypical groups.
Conclusion: Quantitative CT measurements for emphysema and airways correlated well with the dyspnea score and pulmonary function results in patients with COPD. Air-trapping was the most significant parameter between the typical vs. atypical group of COPD patients.

국문 초록 (Abstract)

목적: 만성폐쇄성폐질환 환자에서 임상 증상과 폐기능 검사소견이 일치하는 전형적 환자군과 일치하지 않는 비전형적 환자군을 대상으로 흉부 전산화단층촬영에서 보이는 주요 지표들을 비교 분석함으로써 두 환자군의 차이 및 의의를 알아보고자 하였다.
대상과 방법: 2011년 1월부터 2014년 4월까지 본원에서 만성폐쇄성폐질환으로 확진된 60명의 환자들을 호흡곤란 지수 및 폐기능 검사소견을 토대로 전형군과 비전형군으로 분류하고 이를 세분화 하였다(전형군 1, 호흡곤란 및 폐기능 감소 경미; 전형군 2, 호흡곤란 및 폐기능 감소 심함; 비전형군 1, 호흡곤란 경미, 폐기능 감소 심함; 비전형군 2, 호흡곤란 심함, 폐기능 감소 경미). CT 데이터를 바탕으로 소프트웨어를 이용하여 폐기종 지수, 기도질환, 공기걸림지수에 대한 정량 분석을 시행하였고, 각 소그룹 간에 CT 지표들의 차이를 비교 분석하였다.
결과: 흉부 전산화단층촬영에서 보이는 폐기종 지수는 만성폐쇄성폐질환 환자의 폐기능 검사 결과와 잘 일치하였으며(전형군 1 vs. 비전형군 1, p = 0.032), 기관지 외벽과 내강 면적의 비는 주관적 호흡곤란과 잘 일치하였다(전형군 1 vs. 비전형군 2, p = 0.033). 공기걸림지수는 폐기능 검사 결과(전형군 1 vs. 비전형군 1, p = 0.012) 및 주관적 호흡곤란과 일치하였고(전형군 1 vs. 비전형군 2, p = 0.000), 전형군과 비전형군 사이에 유의한 차이를 보였다.
결론: 만성폐쇄성폐질환 환자들에서 CT를 이용한 폐기종과 기도질환의 정량 분석은 환자의 폐기능 검사 소견 및 주관적 호흡곤란과 유의한 상관관계를 보였으며, 전형군과 비전형군의 주된 차이는 공기걸림이었다.

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