Pulmonary lymphangioleiomyomatosis: analysis of disease manifestation by region-based quantification of lung parenchyma

Theilig, D; Doellinger, F; Kuhnigk, J M; Temmesfeld-Wollbrueck, B; Huebner, R H; Schreiter, N; Pöllinger, Alexander (2015). Pulmonary lymphangioleiomyomatosis: analysis of disease manifestation by region-based quantification of lung parenchyma. European journal of radiology, 84(4), pp. 732-737. Elsevier 10.1016/j.ejrad.2014.12.019

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PURPOSE Lymphangioleiomyomatosis (LAM) is characterized by proliferation of smooth muscle tissue that causes bronchial obstruction and secondary cystic destruction of lung parenchyma. The aim of this study was to evaluate the typical distribution of cystic defects in LAM with quantitative volumetric chest computed tomography (CT). MATERIALS AND METHODS CT examinations of 20 patients with confirmed LAM were evaluated with region-based quantification of lung parenchyma. Additionally, 10 consecutive patients were identified who had recently undergone CT imaging of the lung at our institution, in which no pathologies of the lung were found, to serve as a control group. Each lung was divided into three regions (upper, middle and lower thirds) with identical number of slices. In addition, we defined a "peel" and "core" of the lung comprising the 2 cm subpleural space and the remaining inner lung area. Computerized detection of lung volume and relative emphysema was performed with the PULMO 3D software (v3.42, Fraunhofer MEVIS, Bremen, Germany). This software package enables the quantification of emphysematous lung parenchyma by calculating the pixel index, which is defined as the ratio of lung voxels with a density <-950HU to the total number of voxels in the lung. RESULTS Cystic changes accounted for 0.1-39.1% of the total lung volume in patients with LAM. Disease manifestation in the central lung was significantly higher than in peripheral areas (peel median: 15.1%, core median: 20.5%; p=0.001). Lower thirds of lung parenchyma showed significantly less cystic changes than upper and middle lung areas combined (lower third: median 13.4, upper and middle thirds: median 19.0, p=0.001). CONCLUSION The distribution of cystic lesions in LAM is significantly more pronounced in the central lung compared to peripheral areas. There is a significant predominance of cystic changes in apical and intermediate lung zones compared to the lung bases.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Pöllinger, Alexander

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0720-048X

Publisher:

Elsevier

Language:

English

Submitter:

Aisha Stefania Mzinga

Date Deposited:

17 Mar 2016 10:52

Last Modified:

30 Mar 2016 13:53

Publisher DOI:

10.1016/j.ejrad.2014.12.019

PubMed ID:

25604910

Uncontrolled Keywords:

Computed tomography; Lymphangioleiomyomatosis; Quantitative methods; Thoracic imaging

BORIS DOI:

10.7892/boris.77177

URI:

https://boris.unibe.ch/id/eprint/77177

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