Article: β-thalassemia Major: Thin-Section CT Features and Correlation with Pulmonary Function and Iron Overload

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Titleβ-thalassemia Major: Thin-Section CT Features and Correlation with Pulmonary Function and Iron Overload
AuthorsKhong, PL1
Chan, GCF1
Lee, SL1
Au, WY1
Fong, DYT1
Tsang, KWT1
Ooi, GC1
KeywordsAnemia
Liver, MR
Lung, air trapping
Lung, CT
Lung, function
Issue Date2003
PublisherRadiological Society of North America, Inc. The Journal's web site is located at http://radiology.rsnajnls.org
CitationRadiology, 2003, v. 229 n. 2, p. 507-512 [How to Cite?]
DOI: http://dx.doi.org/10.1148/radiol.2292021805
AbstractPURPOSE: To describe and quantify thin-section computed tomographic (CT) features of the lung in patients with β-thalassemia major (β-TM) and determine the correlation between thin-section CT findings, pulmonary function test (PFT) results, and iron overload. MATERIALS AND METHODS: Forty-one patients with β-TM (mean age, 24.5 years) underwent thin-section CT (during full inspiration and expiration) and PFTs. Two radiologists in consensus recorded the presence of focal bronchial and parenchymal abnormalities and air trapping. A semiquantitative air trapping score (ATS) was used, and patients were separated into air trapping-negative (ATS between 0 and 3) and air trapping-positive (ATS > 3) groups for statistical analysis. Iron overload was estimated by calculating the ratio of the signal intensity (SI) of the liver to the SI of paraspinous muscle by using magnetic resonance imaging in 27 patients (66%). We performed multiple logistic regression analysis to study the influence of age, PFT findings, and SI ratio on the presence of air trapping at CT and multivariate regression analysis to study the simultaneous influence of the presence of air trapping on obstructive PFT indexes. RESULTS: Air trapping was the predominant thin-section CT finding and was seen in 10 (24%) of 41 patients. No patient had interstitial lung disease at CT, although 11 (27%) had a restrictive spirometric pattern. Simple logistic regression analysis revealed significant associations between ATS and forced expiratory volume in the first second (FEV1), FEV1/forced vital capacity (FVC), forced expiratory flow (FEF) in the midexpiratory phase (FEF25%-75%), FEF at 50% of the FVC (FEF50%), and FEF at 75% of the FVC (FEF75%) (P = .019, .030, .007, .034, and .021, respectively) but not between ATS and SI ratio. At multiple logistic regression analysis, only FEF25%-75% was significantly associated with ATS (P = .019, adjusted odds ratio = 0.86, R2 = 41.8%). Multivariate analysis revealed that ATS did not have a significant influence on lung function indexes (P = .104), although significant effects were found with FEV1, FEF25%-75%, FEF50%, and FEF75% when examined separately. CONCLUSION: Air trapping may be present at expiratory thin-section CT in patients with β-TM and is associated with reduced FEF 25%-75% values but not hepatic iron overload. © RSNA, 2003.
ISSN0033-8419
2011 Impact Factor: 5.726
2011 SCImago Journal Rankings: 0.475
DOIhttp://dx.doi.org/10.1148/radiol.2292021805
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorKhong, PL
dc.contributor.authorChan, GCF
dc.contributor.authorLee, SL
dc.contributor.authorAu, WY
dc.contributor.authorFong, DYT
dc.contributor.authorTsang, KWT
dc.contributor.authorOoi, GC
dc.date.accessioned2012-06-26T06:13:50Z
dc.date.available2012-06-26T06:13:50Z
dc.date.issued2003
dc.description.abstractPURPOSE: To describe and quantify thin-section computed tomographic (CT) features of the lung in patients with β-thalassemia major (β-TM) and determine the correlation between thin-section CT findings, pulmonary function test (PFT) results, and iron overload. MATERIALS AND METHODS: Forty-one patients with β-TM (mean age, 24.5 years) underwent thin-section CT (during full inspiration and expiration) and PFTs. Two radiologists in consensus recorded the presence of focal bronchial and parenchymal abnormalities and air trapping. A semiquantitative air trapping score (ATS) was used, and patients were separated into air trapping-negative (ATS between 0 and 3) and air trapping-positive (ATS > 3) groups for statistical analysis. Iron overload was estimated by calculating the ratio of the signal intensity (SI) of the liver to the SI of paraspinous muscle by using magnetic resonance imaging in 27 patients (66%). We performed multiple logistic regression analysis to study the influence of age, PFT findings, and SI ratio on the presence of air trapping at CT and multivariate regression analysis to study the simultaneous influence of the presence of air trapping on obstructive PFT indexes. RESULTS: Air trapping was the predominant thin-section CT finding and was seen in 10 (24%) of 41 patients. No patient had interstitial lung disease at CT, although 11 (27%) had a restrictive spirometric pattern. Simple logistic regression analysis revealed significant associations between ATS and forced expiratory volume in the first second (FEV1), FEV1/forced vital capacity (FVC), forced expiratory flow (FEF) in the midexpiratory phase (FEF25%-75%), FEF at 50% of the FVC (FEF50%), and FEF at 75% of the FVC (FEF75%) (P = .019, .030, .007, .034, and .021, respectively) but not between ATS and SI ratio. At multiple logistic regression analysis, only FEF25%-75% was significantly associated with ATS (P = .019, adjusted odds ratio = 0.86, R2 = 41.8%). Multivariate analysis revealed that ATS did not have a significant influence on lung function indexes (P = .104), although significant effects were found with FEV1, FEF25%-75%, FEF50%, and FEF75% when examined separately. CONCLUSION: Air trapping may be present at expiratory thin-section CT in patients with β-TM and is associated with reduced FEF 25%-75% values but not hepatic iron overload. © RSNA, 2003.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationRadiology, 2003, v. 229 n. 2, p. 507-512 [How to Cite?]
DOI: http://dx.doi.org/10.1148/radiol.2292021805
dc.identifier.doihttp://dx.doi.org/10.1148/radiol.2292021805
dc.identifier.epage512
dc.identifier.isiWOS:000186169700031
dc.identifier.issn0033-8419
2011 Impact Factor: 5.726
2011 SCImago Journal Rankings: 0.475
dc.identifier.issue2
dc.identifier.pmid14595151
dc.identifier.scopuseid_2-s2.0-0142178315
dc.identifier.spage507
dc.identifier.urihttp://hdl.handle.net/10722/150882
dc.identifier.volume229
dc.languageeng
dc.publisherRadiological Society of North America, Inc. The Journal's web site is located at http://radiology.rsnajnls.org
dc.publisher.placeUnited States
dc.relation.ispartofRadiology
dc.relation.referencesReferences in Scopus
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshChild
dc.subject.meshFemale
dc.subject.meshForced Expiratory Flow Rates
dc.subject.meshForced Expiratory Volume
dc.subject.meshHumans
dc.subject.meshIron Overload - Complications - Diagnosis
dc.subject.meshLiver - Pathology
dc.subject.meshLiver Diseases - Complications - Diagnosis
dc.subject.meshLogistic Models
dc.subject.meshLung - Radiography
dc.subject.meshLung Diseases, Obstructive - Complications - Radiography
dc.subject.meshMagnetic Resonance Imaging
dc.subject.meshMale
dc.subject.meshMultivariate Analysis
dc.subject.meshPulmonary Ventilation
dc.subject.meshTomography, X-Ray Computed
dc.subject.meshVital Capacity
dc.subject.meshBeta-Thalassemia - Complications - Physiopathology - Radiography
dc.subjectAnemia
dc.subjectLiver, MR
dc.subjectLung, air trapping
dc.subjectLung, CT
dc.subjectLung, function
dc.titleβ-thalassemia Major: Thin-Section CT Features and Correlation with Pulmonary Function and Iron Overload
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong