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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Studies of regional lung function have developed rapidly in the last few years. Xenon -133 is the most frequently used isotope because of its physiocochemical and biologic properties. Fixed counters are being replaced by the scintillation camera interfaced to a computer allowing easy acquisition and interpretation of results and numerical data. The use of isotopes other than 133Xe, such as 81mKr, is less widespread. In this article, a method is described for studying regional ventilation in which the isotope used is 133Xe, the radioactivity is recorded by a scintillation camera, interfaced to a computer andsix (or 12) regions for both lungs are selected and investigated. The regional ventilation is expressed as an absolute value in ml/min/ml of ventilated volume as well as the relative contribution in percent of each zone to the total ventilation and volume. To illustrate this method, the results are reported for healthy subjects and for patients with chronic bronchitis and emphysema. Scintigraphs of individual cases are presented. Certain theoretic problems related to calculation of regional ventilation are discussed.
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PMID:Radionuclide computerized ventilation studies. 46 18

The results are reported from the radioisotope investigations of the regional blood supply, ventilation and difussion of 133 Xenon from four zones of both lungs in 78 patients with all stages of silicosis and 43 patients with chronic bronchitis--emphysema. Unsystemic and scattered focal disturbances of the separate respiration processes are established. They should be given consideration separately and together with the classical non-isotope investigations, with a view to the making of a precise functional diagnosis and occupational expertise, because they reflect the changes due to the basic disease as well as the other accompanying lung diseases as pneumosclerosis, chronic bronchitis, emphysema, tumors, etc. The complete safety, lack of unpleasant procedures for the patient and sufficient accuracy urge their wider application in practice, including as screening tests.
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PMID:[Radioisotopic diagnosis of regional lung functions in occupational lung diseases]. 65 22

A premature male infant developed bilateral pneumothorax and generalized subcutaneous emphysema following difficult intubation. Xenon 133 imaging revealed accumulation of radionuclide in those areas of subcutaneous emphysema indicating a large air leak from the upper respiratory tract. Pharyngeal injury was confirmed at endoscopy. Imaging with (133)Xe may offer a means of rapid diagnosis of airway injury.
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PMID:Neonatal pharyngeal perforation diagnosed by xenon 133 imaging. 369 99

We have measured regional lung tidal volumes and functional residual capacities by accumulating and framing iso-volumic images while the patient rebreathes 127Xe. As the lung changes shape during ventilation corrections for changes in geometry were obtained by simultaneous collection of 99Tcm counts from the gated perfusion scan. Regions of interest were made to vary throughout the respiratory cycle so that a region had always the same value of 99Tcm counts. From the corrected 127Xe counts regional tidal volumes (TVr) and functional residual capacities (FRCr) were derived. In patients with established chronic bronchitis and emphysema FRCr were greater and the ratio TVr/FRCr decreased compared with patients with relatively normal static and dynamic lung volumes. Preliminary studies suggest that this ratio was a better discriminator between normal and abnormal regional function than estimates of regional xenon washout. Studies with xenon-133 have contributed to our understanding of the physiology of ventilation but have contributed somewhat less to routine clinical practice. This results in part from the unsatisfactory physical properties of xenon-133. Its relatively low gamma ray energy of 80 keV results in significant self-absorption losses and the activity which may be administered is limited by the radiation dose from the associated beta particles so that relatively poor counting statistics are obtained. With inhaled technetium-99m (99Tcm) microspheres imaging conditions are greatly improved but the distribution of these particles may not equate with the distribution of ventilation particularly if wet particles are used. Moreover, simultaneous microsphere perfusion scans with technetium-99m as a label are impossible. Krypton-81m gas has a suitable energy but the short half-life of the rubidium-81m generator (4.7 h) makes supply difficult and the ultrashort half-life of the krypton-81m gas (13 s) leads to problems in calculating the indices of ventilation. Xenon-127 (127Xe) gas has a more favourable dosimetry profile than xenon-133 because it does not have associated beta particles. Further it has an energy (203 keV) suitable for modern gamma cameras and may be used in the presence of injected 99Tcm microspheres to provide simultaneous ventilation/perfusion imaging. Conventional techniques have assumed that a static image of a dynamic process is adequate. As the lungs move during imaging, some account of this respiratory movement should be made.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Regional tidal volume assessed by gated lung imaging. 400 May 64

We measured regional breath sound intensities (Ib) by a microphone amplifier system in 8 subjects with emphysema. We also measured regional white noise transmissions (Tn) from the same areas in all subjects. The recorded areas were 5, 10, 15, and 20 cm from the apex of the lung just lateral to the right anterior midclavicular line. Xenon ventilation indexes (xenon tidal raw counts, an index of total regional ventilation; xenon equilibration raw counts, an index of ventilating lung volume; xenon ventilation per unit volume (Vr), an index of ventilation per unit volume) were also recorded from the same areas. The Ib, Tn, Ib/Tn (an index of sound generation), and xenon ventilation indexes were all expressed as a fraction of the mean value of all four recorded areas. The Ib and Ib/Tn correlated best with the xenon tidal raw counts, correlated well with the xenon equilibration raw counts, and correlated poorly with Vr. We conclude that Ib and Ib/Tn can be used to quantify regional ventilation in subjects with emphysema.
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PMID:Correlation of regional breath sound with regional ventilation in emphysema. 712 39

The authors recommend the use of two functional tests to evaluate the aeration and ventilation modalities of large emphysematous bullae: diffusing capacity by apnea method and ventilation scintigraphs using Xenon 133. In 56 bullous emphysema cases studied, a favorable correlation was observed between the results provided by the two techniques.
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PMID:[Tests concerning aeration or ventilation modalities of voluminous emphysematous bullae (author's transl)]. 746 81

Six patients with pulmonary emphysema scheduled to undergo thoracoscopic lung volume reduction surgery (TLVRS) were evaluated by three-dimensional (3-D) dynamic pulmonary xenon-133 SPECT. Serial 30-second dynamic SPECT data for equilibrium and washout (for 5 min) were acquired using a continuous repetitive rotating acquisition mode with a triple-detector SPECT system. SPECT data were reconstructed to 3-D images with a color, surface-rendering technique, and a 3-D fusion image of the 3-min washout image over the equilibrium image was obtained. Regional ventilation was visually assessed on the fusion 3-D images and quantified by xenon-133 half-washout time (T1/2) and mean transit time (MTT). The 3-D fusion image localized and lateralized the worst diseased sites with xenon-133 retention. Xenon-133 retention, T1/2 and MTT were reduced on these images in five patients with improved pulmonary function tests following TLVRS. However, xenon-133 retention was greater in one with asynchronous diaphragm movement after TLVRS. This modality will assist TLVRS in determining the lung resection target and in evaluating the treatment effect.
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PMID:[Usefulness of 3-D dynamic pulmonary xenon-133 SPECT for thoracoscopic lung volume reduction surgery in patients with pulmonary emphysema]. 912 79

Over the past few years, magnetic resonance imaging (MRI) has emerged as an important instrument for functional ventilation imaging. The aim of this review is to summarize established clinical methods and emerging techniques for research and clinical arenas. Before the advent of MRI, chest radiography and computed tomography (CT) dominated morphological lung imaging, while functional ventilation imaging was accomplished with scintigraphy. Initially, MRI was not used for morphological lung imaging often, due to technical and physical limitations. However, recent developments have considerably improved anatomical MRI, as well as advanced new techniques in functional ventilation imaging, such as inhaled contrast aerosols, oxygen, hyperpolarized noble gases (Helium-3, Xenon-129), and fluorinated gases (sulphur-hexafluoride). Straightforward images demonstrating homogeneity of ventilation and determining ventilated lung volumes can be obtained. Furthermore, new image-derived functional parameters are measurable, such as airspace size, regional oxygen partial pressure, and analysis of ventilation distribution and ventilation/perfusion ratios. There are several advantages to using MRI: lack of radiation, high spatial and temporal resolution and a broad range of functional information. The MRI technique applied in patients with chronic obstructive pulmonary disease, emphysema, cystic fibrosis, asthma, and bronchiolitis obliterans, may yield a higher sensitivity in the detection of ventilation defects than ventilation scintigraphy, CT or standard pulmonary function tests. The next step will be to define the threshold between physiological variation and pathological defects. Using complementary strategies, radiologists will have the tools to characterize the impairment of lung function and to improve specificity.
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PMID:Pulmonary ventilation imaged by magnetic resonance: at the doorstep of clinical application. 1148 4