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首页> 外文期刊>International Journal of Chronic Obstructive Pulmonary Disease >An Integrative Approach of the Fissure Completeness Score and Chartis Assessment in Endobronchial Valve Treatment for Emphysema
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An Integrative Approach of the Fissure Completeness Score and Chartis Assessment in Endobronchial Valve Treatment for Emphysema

机译：裂缝完整性得分的一体化方法和肺气肿治疗内心阀门治疗中的图表评估

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Purpose: Lung volume reduction using one-way endobronchial valves is a bronchoscopic treatment for patients with severe emphysema without collateral ventilation between the treatment target lobe and the ipsilateral lobe(s). CT-scan fissure analysis is often used as a surrogate to predict the absence of collateral ventilation. We aimed to evaluate the predictive value of the fissure completeness score (FCS) compared to the functional Chartis measurement of collateral ventilation and to provide cut-off values of the FCS in patient selection. Patients and Methods: Multicenter study in patients eligible for treatment with one-way valves. The FCS was calculated by quantitative CT analysis (Thirona, the Netherlands) and compared to status of interlobar collateral ventilation measured with Chartis system (PulmonX, USA). Thresholds were calculated for the predictive values of the presence of collateral ventilation. Results: An FCS 95% of the left major fissure had a positive predictive value (PPV) of 91%, with 1 in 11 fissures demonstrating collateral ventilation with Chartis measurement, whereas an FCS of ≤ 80% had a negative predictive value (NPV) of 100% for the presence of collateral ventilation. For the right major fissure, the NPV was 100% for an FCS ≤ 90%, but 69.7% for the right upper lobe fissure. Conclusion: Quantitative CT analysis is recommended in all patients evaluated for endobronchial valves. Patients with incomplete fissures (left major fissure: FCS 80%; right major fissure: 90%) can be excluded from Chartis measurement and endobronchial valve treatment. In patients with more complete fissures, the FCS is not specific enough for endobronchial valve treatment decisions. In this case, additional Chartis measurements are always recommended in the right lung. For the left lung, Chartis assessments may be omitted if the FCS is 95%.
机译：目的：使用单向内瓣阀的肺体积减少是对患有严重肺气肿的患者的支气管镜检查，无需治疗靶叶和同侧瓣膜之间的抵押通气。 CT扫描裂缝分析通常用作预测抵消通风的替代物。与抵押通气的功能图表测量相比，我们旨在评估裂隙完整性得分（FCS）的预测值，并在患者选择中提供FCS的截止值。患者及方法：用单向阀有资格治疗患者的多中心研究。通过定量CT分析（Thirona，Netherlands）计算FCS，与用Chartis系统（Pulmonx，USA）测量的间隔侧支通风的状态进行比较。计算抵押通风的存在的预测值的阈值。结果：FCS> 95％的左主裂隙的阳性预测值（PPV）为91％，11个裂隙中有1个，展示副通风，图表测量，≤80％的FCS具有负预测值（NPV ）抵押通风的存在100％。对于正确的主要裂隙，FCS≤90％的NPV为100％，但右上叶裂隙为69.7％。结论：在为胚胎阀评估的所有患者中建议使用定量CT分析。裂缝不完全的患者（左重大裂缝：FCS <80％;右重大裂缝：<90％）可以从Chartis测量和内核阀门处理中排除。在更完整的裂缝患者中，FCS不足以足以用于内核阀门治疗决策。在这种情况下，始终建议在右侧肺部进行额外的图表测量。对于左肺，如果FCS> 95％，则可能省略图表评估。

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