Difference in diaphragmatic motion during tidal breathing in a standing position between COPD patients and normal subjects: Time-resolved quantitative evaluation using dynamic chest radiography with flat panel detector system ("dynamic X-ray phrenicography")

作者：Yamada Yoshitake^*; Ueyama Masako; Abe Takehiko; Araki Tetsuro; Abe Takayuki; Nishino Mizuki; Jinzaki Masahiro; Hatabu Hiroto^*; Kudoh Shoji

来源：European Journal of Radiology, 2017, 87: 76-82.

DOI：10.1016/j.ejrad.2016.12.014

• Radiography
• Chronic obstructive pulmonary disease
• X-ray
• Respiration
• Diaphragm

Objectives: To quantitatively compare diaphragmatic motion during tidal breathing in a standing position between chronic obstructive pulmonary disease (COPD) patients and normal subjects using dynamic chest radiography.
Materials and methods: Thirty-nine COPD patients (35 males; age, 71.3 +/- 8.4 years) and 47 normal subjects (non-smoker healthy volunteers) (20 males; age, 54.8 +/- 9.8 years) underwent sequential chest radiographs during tidal breathing using dynamic chest radiography with a flat panel detector system. We evaluated the excursions and peak motion speeds of the diaphragms. The results were analyzed using an unpaired t-test and a multiple linear regression model.
Results: The excursions of the diaphragms in COPD patients were significantly larger than those in normal subjects (right, 14.7 +/- 5.5 mm vs. 10.2 +/- 3.7 mm, respectively, P < 0.001; left, 17.2 +/- 4.9 mm vs. 14.9 + 4.2 mm, respectively, P = 0.022). Peak motion speeds in inspiratory phase were significantly faster in COPD patients compared to normal subjects (right, 16.3 +/- 5.0 mm/s vs. 11.8 +/- 4.2 mm/s, respectively, P < 0.001; left, 18.9 +/- 4.9 mm/s vs. 16.7 +/- 4.0 mm/s, respectively, P = 0.022). The multivariate analysis demonstrated that having COPD and higher body mass index were independently associated with increased excursions of the bilateral diaphragm (all P < 0.05), after adjusting for other clinical variables.
Conclusions: Time-resolved quantitative evaluation of the diaphragm using dynamic chest radiography demonstrated that the diaphragmatic motion during tidal breathing in a standing position is larger and faster in COPD patients than in normal subjects.

• 出版日期2017-2