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Breathing levels during inspiration and expiration HRCT

Mischa Niederer, Bernadette Aalders, Esmeralda Krop, Jack Spithoven, Pim De Jong, Jos Rooyackers
European Respiratory Journal 2014 44: P4267; DOI:
Mischa Niederer
1Netherlands Expertise Centre for Occupationale Disorders, Netherlands Expertise Centre for Occupationale Disorders, Utrecht, Netherlands
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Bernadette Aalders
1Netherlands Expertise Centre for Occupationale Disorders, Netherlands Expertise Centre for Occupationale Disorders, Utrecht, Netherlands
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Esmeralda Krop
2Institute for Risk Assesment Sciences, University Utrecht, Utrecht, Netherlands
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Jack Spithoven
2Institute for Risk Assesment Sciences, University Utrecht, Utrecht, Netherlands
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Pim De Jong
3Division of Radiology, University Medical Centre Utrecht, Utrecht, Netherlands
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Jos Rooyackers
1Netherlands Expertise Centre for Occupationale Disorders, Netherlands Expertise Centre for Occupationale Disorders, Utrecht, Netherlands
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Abstract

Introduction: Inadequate breathing manoeuvres during inspiratory and expiratory High Resolution Computed Tomography (HRCT) may conceal differences in lung density. Although spirometer-controlled HRCT is advocated, this technique is not common practice. The aim of this study was to determine breathing levels during inspiration and expiration HRCT as achieved after standard breathing instructions by the radiology assistant.

Methods: during HRCT Inspiratory Capacity (ICinsp,CT) and Expiratory Reserve Volume (ERVexp,CT) were measured in 29 male construction workers (age 49 ±7 yrs; FEV1/VC 75± 0,1 %) at risk for silicosis and compared with lung function (ICLF, ERVLF) performed after HRCT under similar conditions by a respiratory technician according to ERS/ATS criteria. Vital Capacity was measured during lung function (VCLF) and for HRCT calculated by adding IC and ERV using two different manoeuvres (VCconstr,CT). Instructions of the radiology assistant and the moment at which the scan was started were recorded.

Results: ICinsp,CT was 0.85 l (0.7 l) and VCconstr,CT (0.6 l) 0.88 l lower as compared to lung function (p< 0,01). The difference was > 20% in 16 and 13 workers respectively. ERV did not differ significantly between HRCT and lung function. In 15/29 workers ERVexp,CT exceeded ERVLF because of changes in resting breathing level. Expiration HRCT was started during the expiration phase in 24/29 workers.

Conclusion: inspiratory and expiratory breathing levels during HRCT did not reach maximal levels as achieved during lung function. Spirometer-controlled or -triggered HRCT should be considered. However, the effect of these methods on the diagnostic yield of HRCT in interstitial lung disease has yet to be determined.

  • Spirometry
  • Lung function testing
  • Imaging
  • © 2014 ERS
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Breathing levels during inspiration and expiration HRCT
Mischa Niederer, Bernadette Aalders, Esmeralda Krop, Jack Spithoven, Pim De Jong, Jos Rooyackers
European Respiratory Journal Sep 2014, 44 (Suppl 58) P4267;

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Breathing levels during inspiration and expiration HRCT
Mischa Niederer, Bernadette Aalders, Esmeralda Krop, Jack Spithoven, Pim De Jong, Jos Rooyackers
European Respiratory Journal Sep 2014, 44 (Suppl 58) P4267;
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