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Quantitative CT-based structural alterations of segmental airways in cement dust-exposed subjects

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Authors
Kim, Taewoo; Cho, Hyun Bin; Kim, Woo Jin; Lee, Chang Hyun; Chae, Kum Ju; Choi, So-Hyun; Lee, Kyeong Eun; Bak, So Hyeon; Kwon, Sung Ok; Jin, Gong Yong; Choi, Jiwoong; Park, Eun-Kee; Lin, Ching-Long; Hoffman, Eric A; Choi, Sanghun
Issue Date
2020-05-29
Publisher
BMC
Citation
Respiratory Research. 2020 May 29;21(1):133
Keywords
Airway narrowingWall thickeningBifurcation angleStiffness of airway structurePercent emphysema
Abstract
Background
Dust exposure has been reported as a risk factor of pulmonary disease, leading to alterations of segmental airways and parenchymal lungs. This study aims to investigate alterations of quantitative computed tomography (QCT)-based airway structural and functional metrics due to cement-dust exposure.

Methods
To reduce confounding factors, subjects with normal spirometry without fibrosis, asthma and pneumonia histories were only selected, and a propensity score matching was applied to match age, sex, height, smoking status, and pack-years. Thus, from a larger data set (N = 609), only 41 cement dust-exposed subjects were compared with 164 non-cement dust-exposed subjects. QCT imaging metrics of airway hydraulic diameter (Dh), wall thickness (WT), and bifurcation angle (θ) were extracted at total lung capacity (TLC) and functional residual capacity (FRC), along with their deformation ratios between TLC and FRC.

Results
In TLC scan, dust-exposed subjects showed a decrease of Dh (airway narrowing) especially at lower-lobes (p < 0.05), an increase of WT (wall thickening) at all segmental airways (p < 0.05), and an alteration of θ at most of the central airways (p < 0.001) compared with non-dust-exposed subjects. Furthermore, dust-exposed subjects had smaller deformation ratios of WT at the segmental airways (p < 0.05) and θ at the right main bronchi and left main bronchi (p < 0.01), indicating airway stiffness.

Conclusions
Dust-exposed subjects with normal spirometry demonstrated airway narrowing at lower-lobes, wall thickening at all segmental airways, a different bifurcation angle at central airways, and a loss of airway wall elasticity at lower-lobes. The airway structural alterations may indicate different airway pathophysiology due to cement dusts.
ISSN
1465-993X
Language
English
URI
http://hdl.handle.net/10371/168594
DOI
https://doi.org/10.1186/s12931-020-01399-9
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College of Medicine/School of Medicine (의과대학/대학원)Radiology (영상의학전공)Journal Papers (저널논문_영상의학전공)
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