Application of automated bronchial 3D-CT measurement in pulmonary contusion complicated with acute respiratory distress syndrome.

BACKGROUNDQuantitative measurement of bronchial morphological changes in pulmonary contusion with acute respiratory distress syndrome (ARDS) has important clinical implications.OBJECTIVETo investigate the morphological changes in bronchus before and after treatment in patients with pulmonary contusion combined with ARDS using an automated bronchial three-dimensional computed tomography (3D-CT) measurement method.METHODSThe study involves a dataset of CT images of 62 patients diagnosed with pulmonary contusion combined with ARDS. The volume of pulmonary contusion lesions was calculated as a percentage of the total lung volume using the automated 3D-CT method. The bronchial luminal cross-sectional area, wall cross-sectional area, the maximum and average wall thickness, the maximum and average luminal densities, intraluminal and extraluminal diameters, and circumferences of generations 2-4 bronchi before and after treatment were measured. Furthermore, the corresponding differences were analyzed statistically.RESULTSThe luminal cross-sectional area, wall cross-sectional area, intraluminal and extraluminal diameters, and circumferences of generations 2-4 bronchi were all significantly lower before treatment than after treatment (P < 0.05). However, the maximum and average wall thicknesses were both significantly higher before treatment than after treatment (P < 0.05). No significant difference was found in the maximum and average luminal densities before and after treatment (P > 0.05). The percentage of the pulmonary contusion lesion volume to the total lung volume correlated positively with the thoracic trauma severity score (r = 0.74, P < 0.01).CONCLUSIONSQuantitative bronchial CT image analysis enables to detect and assess bronchial morphological changes in patients diagnosed with pulmonary contusion combined with ARDS.