Journal of Applied Physiology
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J Appl Physiol (February 7, 2008). doi:10.1152/japplphysiol.00212.2007
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Submitted on February 20, 2007
Accepted on February 4, 2008

CT Measured Regional Specific Volume Change Reflects Regional Ventilation in Supine Sheep

Matthew K. Fuld1, R. Blaine Easley2, Osama I. Saba3, Deokiee Chon3, Joseph M. Reinhardt3, Eric A. Hoffman4, and Brett A. Simon5*

1 Anesthesiology and Critical Care Medicine, The Johns Hopkins University, Baltimore, Maryland, United States; Baltimore, Maryland, United States
2 Anesthesiology and Critical Care Medicine, The Johns Hopkins University, Baltimore, Maryland, United States
3 Biomedical Engineering, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
4 Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States; Biomedical Engineering, University of Iowa Carver College of Medicine, Iowa City, Iowa, United States
5 Anesthesiology and Critical Care Medicine, The Johns Hopkins University, Baltimore, Maryland, United States; Medicine, The Johns Hopkins University, Baltimore, Maryland, United States

* To whom correspondence should be addressed. E-mail: bsimon{at}jhmi.edu.

CT imaging techniques permit the non-invasive measurement of regional lung function. Regional specific volume change (sVol), determined from the change in lung density over a tidal breath, should correlate with regional ventilation and regional lung expansion measured with other techniques. sVol was validated against xenon (Xe)-CT specific ventilation (sV) in four anesthetized, intubated, mechanically ventilated sheep. Xe-CT used expiratory gated axial scanning during the washin and washout of 55% Xe. sVol was measured from the tidal changes in tissue density (H, houndsfield units) of lung regions using the relationship: sVol = (1000 (Hi-He)) / (He (1000+Hi)) where He and Hi are expiratory and inspiratory regional density. Distinct anatomical markings were used to define corresponding lung regions of interest between inspiratory, expiratory, and Xe-CT images, with an average region of interest size of 1.6±0.7 ml. In addition, sVol was compared to regional volume changes measured directly from the positions of implanted metal markers in an additional animal. A linear relationship between sVol and sV was demonstrated over a wide range of regional sV found in the normal supine lung, with an overall correlation coefficient (R2) of 0.66. There was a tight correlation (R2=0.97) between marker-measured volume changes and sVol. Regional sVol, which involves significantly reduced exposure to radiation and Xe gas compared to the Xe-CT method, represents a safe and efficient surrogate for measuring regional ventilation in experimental studies and patients.







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