2-1 超高分解能CTを用いた慢性肺疾患の末梢病変描出と病態生理の類推(<特集>第28回日本呼吸器内視鏡学会総会)

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Morphological remodeling is induced in the course of many chronic lung diseases and changes the gas kinetics in lung periphery. Therefore, respiratory failure is caused by remodeling. Some previous studies showed that ultra-high-resolution CT (UHRCT) demonstrates alveolar walls clearly and can show the peripheral lung structure in three-dimensional (3-D) with non-invasive imaging. The synchrotron radiation CT (SRCT) and the micro focus X-ray CT (MFXCT) were used in our studies as UHRCT. SRCT images were obtained by a SRCT system constructed in SPring-8 (Hyogo, Japan). On the other hands, MFXCT is featured by cone-beam X-ray, and has been used as industrial CT for quality and security check. In normal lung, alveolar wall can be visualized with approximately 10-μm of spatial resolution using UHRCT. Additionally, UHRCT can provide 3-D information of lung periphery of an inflated and fixed lung specimen that keeps inflation like in vivo. In pulmonary fibrosis, the gas-exchanging area is definitely decreased due to the traction dilatation. In addition, it is assumed that the compliance of peripheral airway is decreased due to surrounding fibrosis. In emphysema, UHRCT demonstrates that the peripheral airways and airspaces beyond respiratory bronchioles were dilated and destroyed. It showed peripheral remodeling of emphysematous change on a microscopic level. The peripheral bronchioles were narrower than those in normal. It suggested that the peripheral check-valve mechanism worked in those peripheral airways. Ultra high-resolution CT can clearly demonstrate the peripheral normal structure and the remodeling in chronic lung disease at microscopic level. It would be useful to verify the morphologic corroboration of pathophysiology in lung periphery.
日本呼吸器内視鏡学会の論文
2005-12-25

2-1 超高分解能CTを用いた慢性肺疾患の末梢病変描出と病態生理の類推(<特集>第28回日本呼吸器内視鏡学会総会)

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