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letter
. 1988 Oct;80(10):1073–1078.

Scintigraphic Evidence for Relief of Airways Obstruction in Cystic Fibrosis

Richard M Millis, Lucas L Kulczycki, John C Harbert
PMCID: PMC2625869  PMID: 3249313

Abstract

A simple scheme for quantifying lung perfusion scintigrams was developed to evaluate the efficacy of a therapeutic regimen for the relief of airways obstruction in cystic fibrosis patients. Ten hospitalized patients were given conventional therapy including administration of intravenous antibiotics, mucolytic aerosols, chest physical therapy, and adequate nutrition and hydration as adjuncts to a single bronchoscopic bronchial washing procedure. Quantitative scoring of the lung scintigram was based upon the severity of the perfusion defects in equivalent upper and lower lung fields, as viewed from right and left posterior oblique projections. Seven to ten days following bronchoscopic washing, scintigraphic scores were found to correlate with changes in both the forced vital capacity and the one-second, time forced expiratory volume (r = 0.78, 0.70, respectively; P <.05). The severity of defective lung perfusion indicated the loss of lung volume and perfusion due to airways obstruction and secondary hypoxic vasoconstriction. Chest radiography was less reflective of improvement than lung scintigraphy. It was concluded that serial pulmonary perfusion scintigrams provide a sensitive tool for evaluating the relief of airways obstruction in cystic fibrosis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anthonisen N. R., Bass H., Oriol A., Place R. E., Bates D. V. Regional lung function in patients with chronic bronchitis. Clin Sci. 1968 Dec;35(3):495–511. [PubMed] [Google Scholar]
  2. Bass H., Heckscher T., Anthonisen N. R. Regional pulmonary gas exchange in patients with pulmonary embolism. Clin Sci. 1967 Oct;33(2):355–364. [PubMed] [Google Scholar]
  3. Beier F. R., Renzetti A. D., Jr, Mitchell M., Watanabe S. Pulmonary pathophysiology in cystic fibrosis. Am Rev Respir Dis. 1966 Sep;94(3):430–440. doi: 10.1164/arrd.1966.94.3.430. [DOI] [PubMed] [Google Scholar]
  4. Brach B. B., Chao R. P., Sgroi V. L., Minh V. D., Ashburn W. L., Moser K. M. 133Xenon washout patterns during diaphragmatic breathing. Studies in normal subjects and patients with chronic obstructive pulmonary disease. Chest. 1977 Jun;71(6):735–739. doi: 10.1378/chest.71.6.735. [DOI] [PubMed] [Google Scholar]
  5. Braunstein M. S., Fleegler B. Failure of bronchopulmonary lavage in cystic fibrosis. Chest. 1974 Jul;66(1):96–99. doi: 10.1378/chest.66.1.96. [DOI] [PubMed] [Google Scholar]
  6. Cropp G. J. Relative sensitivity of different pulmonary function tests in the evaluation of exercise-induced asthma. Pediatrics. 1975 Nov;56(5 PT-2):860–867. [PubMed] [Google Scholar]
  7. Ewing C. W. Role of the fiberoptic bronchoscope in lung lavage of patients with cystic fibrosis. Chest. 1978 May;73(5 Suppl):750–754. doi: 10.1378/chest.73.5_supplement.750. [DOI] [PubMed] [Google Scholar]
  8. Fishman A. P. Hypoxia on the pulmonary circulation. How and where it acts. Circ Res. 1976 Apr;38(4):221–231. doi: 10.1161/01.res.38.4.221. [DOI] [PubMed] [Google Scholar]
  9. Fraser R. G. The radiologist and obstructive airway disease. Caldwell Lecture, 1973. Am J Roentgenol Radium Ther Nucl Med. 1974 Apr;120(4):737–775. doi: 10.2214/ajr.120.4.737. [DOI] [PubMed] [Google Scholar]
  10. Heckscher T., Bass H., Oriol A., Rose B., Anthoniesen N. R., Bates D. V. Regional lung function in patients with bronchial asthma. J Clin Invest. 1968 May;47(5):1063–1070. doi: 10.1172/JCI105796. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kjellman B. Lung function in children with pneumonia. With special reference to distribution of inspired air and regional lung function. Scand J Respir Dis. 1968;49(3):185–201. [PubMed] [Google Scholar]
  12. Kylstra J. A., Rausch D. C., Hall K. D., Spock A. Volume-controlled lung lavage in the treatment of asthma, bronchiectasis, and mucoviscidosis. Am Rev Respir Dis. 1971 May;103(5):651–665. doi: 10.1164/arrd.1971.103.5.651. [DOI] [PubMed] [Google Scholar]
  13. Lober C. W., Saltzman H. A., Kylstra J. A. Volume-controlled lung lavage in a woman with cystic fibrosis. Chest. 1975 Sep;68(3):382–383. doi: 10.1378/chest.68.3.382. [DOI] [PubMed] [Google Scholar]
  14. Lupi E., Dumont C., Tejada V. M., Horwitz S., Galland F. A radiologic index of pulmonary arterial hypertension. Chest. 1975 Jul;68(1):28–31. doi: 10.1378/chest.68.1.28. [DOI] [PubMed] [Google Scholar]
  15. Millis R. M., Young R. C., Jr, Kulczycki L. L. Validation of therapeutic bronchoscopic bronchial washing in cystic fibrosis. Chest. 1977 Apr;71(4):508–513. doi: 10.1378/chest.71.4.508. [DOI] [PubMed] [Google Scholar]
  16. Nicklaus T. M., Stowell D. W., Christiansen W. R., Renzetti A. D., Jr The accuracy of the roentgenologic diagnosis of chronic pulmonary emphysema. Am Rev Respir Dis. 1966 Jun;93(6):889–899. doi: 10.1164/arrd.1966.93.6.889. [DOI] [PubMed] [Google Scholar]
  17. Quick C. A., Warwick W. Bronchoscopy and lavage in management of pulmonary complications of cystic fibrosis. Chest. 1978 May;73(5 Suppl):755–758. doi: 10.1378/chest.73.5_supplement.755. [DOI] [PubMed] [Google Scholar]
  18. Sobol B. J., Emirgil C. The First Second Timed vital capacity and the course of obstructive lung diseases. Chest. 1977 Jul;72(1):81–83. doi: 10.1378/chest.72.1.81. [DOI] [PubMed] [Google Scholar]
  19. THOMPSON H. T., PRYOR W. J. BRONCHIAL LAVAGE IN THE TREATMENT OF OBSTRUCTIVE LUNG DISEASE. Lancet. 1964 Jul 4;2(7349):8–10. doi: 10.1016/s0140-6736(64)90004-2. [DOI] [PubMed] [Google Scholar]

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