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Thin-Section CT in Patients with Cystic Fibrosis: Correlation with Peak Exercise Capacity and Body Mass Index¹

¹ From the Department of Radiology (J.D.D., S.J.S., J.B.M.) and The National Referral Centre for Adult Cystic Fibrosis (S.C.B., R.B.M.B., C.G.G.), St Vincent's University Hospital, Dublin, Ireland. Received March 26, 2005; revision requested May 19; revision received August 17; final version accepted September 14. Supported by the Health Research Board of Ireland, the Cystic Fibrosis Research Trust Fund of Ireland, and the Department of Radiology, St Vincent's University Hospital. Address correspondence to J.D.D., Department of Radiology, Vancouver General Hospital, 855 W 12th Ave, Vancouver, BC, Canada V6K 1R4 (e-mail: jddodd{at}partners.org).

View larger version (17K): [in a new window]   Figure 1: Graph shows correlation between thin-section CT (HRCT) Bhalla score and percentage of predicted peak O2 uptake (R = 0.60, P < .01). As thin-section CT score increases (indicating worsening structural lung disease), percentage of predicted peak O2 uptake decreases (indicating worsening exercise tolerance).

View larger version (128K): [in a new window]   Figure 2a: (a) Transverse thin-section (1-mm-thick) CT scan in a 26-year-old man with mild CF, as scored by both radiologists. Abnormalities include mild bronchiectasis (straight solid arrow), peribronchial thickening (open arrow), and peripheral mucus plugging (curved arrow). (b) Corresponding exercise graph shows O2 uptake (VO2) () and workload; there is mild exercise impairment, with a peak O2 uptake of 3.2 L/min and a peak workload of 227 W. (c) Transverse thin-section (1-mm-thick) CT scan in a 28-year-old woman with moderate CF, as scored by both radiologists. Abnormalities include moderate changes of bronchiectasis (straight arrows) and subsegmental collapse (curved arrow); note anterior deviation of the horizontal fissure. (d) Corresponding exercise graph shows O2 uptake () and workload; there is moderate exercise impairment, with a peak O2 uptake of 1.4 L/min and a peak workload of 124 W. (e) Transverse thin-section (1-mm-thick) CT scan in a 23-year-old man with severe CF, as scored by both radiologists. Thin-section CT abnormalities include severe bronchiectasis (curved arrow), severe peribronchial thickening (open arrow), and large bullae (straight solid arrow). (f) Corresponding exercise graph shows O2 uptake () and workload; there is severe exercise impairment, with a peak O2 uptake of 0.86 L/min and a peak workload of 72 W.

View larger version (34K): [in a new window]   Figure 2b: (a) Transverse thin-section (1-mm-thick) CT scan in a 26-year-old man with mild CF, as scored by both radiologists. Abnormalities include mild bronchiectasis (straight solid arrow), peribronchial thickening (open arrow), and peripheral mucus plugging (curved arrow). (b) Corresponding exercise graph shows O2 uptake (VO2) () and workload; there is mild exercise impairment, with a peak O2 uptake of 3.2 L/min and a peak workload of 227 W. (c) Transverse thin-section (1-mm-thick) CT scan in a 28-year-old woman with moderate CF, as scored by both radiologists. Abnormalities include moderate changes of bronchiectasis (straight arrows) and subsegmental collapse (curved arrow); note anterior deviation of the horizontal fissure. (d) Corresponding exercise graph shows O2 uptake () and workload; there is moderate exercise impairment, with a peak O2 uptake of 1.4 L/min and a peak workload of 124 W. (e) Transverse thin-section (1-mm-thick) CT scan in a 23-year-old man with severe CF, as scored by both radiologists. Thin-section CT abnormalities include severe bronchiectasis (curved arrow), severe peribronchial thickening (open arrow), and large bullae (straight solid arrow). (f) Corresponding exercise graph shows O2 uptake () and workload; there is severe exercise impairment, with a peak O2 uptake of 0.86 L/min and a peak workload of 72 W.

View larger version (132K): [in a new window]   Figure 2c: (a) Transverse thin-section (1-mm-thick) CT scan in a 26-year-old man with mild CF, as scored by both radiologists. Abnormalities include mild bronchiectasis (straight solid arrow), peribronchial thickening (open arrow), and peripheral mucus plugging (curved arrow). (b) Corresponding exercise graph shows O2 uptake (VO2) () and workload; there is mild exercise impairment, with a peak O2 uptake of 3.2 L/min and a peak workload of 227 W. (c) Transverse thin-section (1-mm-thick) CT scan in a 28-year-old woman with moderate CF, as scored by both radiologists. Abnormalities include moderate changes of bronchiectasis (straight arrows) and subsegmental collapse (curved arrow); note anterior deviation of the horizontal fissure. (d) Corresponding exercise graph shows O2 uptake () and workload; there is moderate exercise impairment, with a peak O2 uptake of 1.4 L/min and a peak workload of 124 W. (e) Transverse thin-section (1-mm-thick) CT scan in a 23-year-old man with severe CF, as scored by both radiologists. Thin-section CT abnormalities include severe bronchiectasis (curved arrow), severe peribronchial thickening (open arrow), and large bullae (straight solid arrow). (f) Corresponding exercise graph shows O2 uptake () and workload; there is severe exercise impairment, with a peak O2 uptake of 0.86 L/min and a peak workload of 72 W.

View larger version (21K): [in a new window]   Figure 2d: (a) Transverse thin-section (1-mm-thick) CT scan in a 26-year-old man with mild CF, as scored by both radiologists. Abnormalities include mild bronchiectasis (straight solid arrow), peribronchial thickening (open arrow), and peripheral mucus plugging (curved arrow). (b) Corresponding exercise graph shows O2 uptake (VO2) () and workload; there is mild exercise impairment, with a peak O2 uptake of 3.2 L/min and a peak workload of 227 W. (c) Transverse thin-section (1-mm-thick) CT scan in a 28-year-old woman with moderate CF, as scored by both radiologists. Abnormalities include moderate changes of bronchiectasis (straight arrows) and subsegmental collapse (curved arrow); note anterior deviation of the horizontal fissure. (d) Corresponding exercise graph shows O2 uptake () and workload; there is moderate exercise impairment, with a peak O2 uptake of 1.4 L/min and a peak workload of 124 W. (e) Transverse thin-section (1-mm-thick) CT scan in a 23-year-old man with severe CF, as scored by both radiologists. Thin-section CT abnormalities include severe bronchiectasis (curved arrow), severe peribronchial thickening (open arrow), and large bullae (straight solid arrow). (f) Corresponding exercise graph shows O2 uptake () and workload; there is severe exercise impairment, with a peak O2 uptake of 0.86 L/min and a peak workload of 72 W.

View larger version (136K): [in a new window]   Figure 2e: (a) Transverse thin-section (1-mm-thick) CT scan in a 26-year-old man with mild CF, as scored by both radiologists. Abnormalities include mild bronchiectasis (straight solid arrow), peribronchial thickening (open arrow), and peripheral mucus plugging (curved arrow). (b) Corresponding exercise graph shows O2 uptake (VO2) () and workload; there is mild exercise impairment, with a peak O2 uptake of 3.2 L/min and a peak workload of 227 W. (c) Transverse thin-section (1-mm-thick) CT scan in a 28-year-old woman with moderate CF, as scored by both radiologists. Abnormalities include moderate changes of bronchiectasis (straight arrows) and subsegmental collapse (curved arrow); note anterior deviation of the horizontal fissure. (d) Corresponding exercise graph shows O2 uptake () and workload; there is moderate exercise impairment, with a peak O2 uptake of 1.4 L/min and a peak workload of 124 W. (e) Transverse thin-section (1-mm-thick) CT scan in a 23-year-old man with severe CF, as scored by both radiologists. Thin-section CT abnormalities include severe bronchiectasis (curved arrow), severe peribronchial thickening (open arrow), and large bullae (straight solid arrow). (f) Corresponding exercise graph shows O2 uptake () and workload; there is severe exercise impairment, with a peak O2 uptake of 0.86 L/min and a peak workload of 72 W.

View larger version (19K): [in a new window]   Figure 2f: (a) Transverse thin-section (1-mm-thick) CT scan in a 26-year-old man with mild CF, as scored by both radiologists. Abnormalities include mild bronchiectasis (straight solid arrow), peribronchial thickening (open arrow), and peripheral mucus plugging (curved arrow). (b) Corresponding exercise graph shows O2 uptake (VO2) () and workload; there is mild exercise impairment, with a peak O2 uptake of 3.2 L/min and a peak workload of 227 W. (c) Transverse thin-section (1-mm-thick) CT scan in a 28-year-old woman with moderate CF, as scored by both radiologists. Abnormalities include moderate changes of bronchiectasis (straight arrows) and subsegmental collapse (curved arrow); note anterior deviation of the horizontal fissure. (d) Corresponding exercise graph shows O2 uptake () and workload; there is moderate exercise impairment, with a peak O2 uptake of 1.4 L/min and a peak workload of 124 W. (e) Transverse thin-section (1-mm-thick) CT scan in a 23-year-old man with severe CF, as scored by both radiologists. Thin-section CT abnormalities include severe bronchiectasis (curved arrow), severe peribronchial thickening (open arrow), and large bullae (straight solid arrow). (f) Corresponding exercise graph shows O2 uptake () and workload; there is severe exercise impairment, with a peak O2 uptake of 0.86 L/min and a peak workload of 72 W.