Structural and functional alterations of subjects with cement dust exposure: A longitudinal quantitative computed tomography-based study

초록

Cement dust exposure (CDE) can be a risk factor for pulmonary disease, causing changes in segmental airways and parenchymal lungs. This study investigates longitudinal alterations in quantitative computed tomography (CT)-based metrics due to CDE. We obtained CT-based airway structural and lung functional metrics from CDE subjects with baseline CT and follow-up CT scans performed three years later. From the CT, we extracted wall thickness (WT) and bifurcation angle (theta) at total lung capacity (TLC) and functional residual capacity (FRC), respectively. We also computed air volume (V-air), tissue volume (V-tissue), global lung shape, percentage of emphysema (E-mph%), and more. Clinical measures were used to associate with CT-based metrics. Three years after their baseline, the pulmonary function tests of CDE subjects were similar or improved, but there were significant alterations in the CT-based structural and functional metrics. The follow-up CT scans showed changes in theta at most of the central airways; increased WT at the subgroup bronchi; smaller V(air )at TLC at all except the right upper and lower lobes; smaller V-tissue at all lobes in TLC and FRC except for the upper lobes in FRC; smaller global lung shape; and greater E-mph% at the right upper and lower lobes. CT-based structural and functional variables are more sensitive to the early identification of CDE subjects, while most clinical lung function changes were not noticeable. We speculate that the significant long-term changes in CT are uniquely observed in CDE subjects, different from smoking-induced structural changes.

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