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Computed Tomography (CT)–Based Analysis of Regional Lung Ventilation

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Mechanics of Breathing

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Abstract

Classical studies on regional ventilation with lobar spirometry [1, 2] and radioactive gases [3, 4] demonstrated regional differences in the distribution of ventilation, preferentially toward the lower lung zones. The first quantitative results are reported by West and Dollery [3], measuring the removal rate of oxygen15-labeled carbon dioxide after a single breath of the radioactive gas by external counting, and by Ball et al. [4], who measured regional ventilation by xenon scintigraphy by relating the lung count rate after a single breath to that after isotope equilibration throughout the lung. These preliminary findings have demonstrated that the lower portion of the lung is better ventilated and receives a much greater fraction of the total pulmonary blood flow and that the middle and lower portions of the lung are better ventilated on the left than on the right during deep inspiration. Subsequent works from Milic-Emili and coworkers [5, 6] attributed this behavior to the combined effect of the gradient of pleural pressure and the static volume-pressure relation of the lung. They have demonstrated that there is a vertical gradient of pleural pressure which causes nondependent portion of the lung to be relatively more expanded than the dependent. Moreover, these more distended units at the top of the lung are on a flatter part of their pressure-volume curve than the smaller units at the bottom; thus, equal pressure increments produce smaller volume increments at the top than at the bottom of the lung (Fig. 15.1).

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Authors and Affiliations

  1. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, P.zza L. da Vinci, 32, Milano, 20133, Italy

    Andrea Aliverti PhD, Francesca Pennati & Caterina Salito

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  1. Andrea Aliverti PhD
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  2. Francesca Pennati
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Correspondence to Andrea Aliverti PhD .

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  1. Politecnico di Milano, Milano, Italy

    Andrea Aliverti

  2. Politecnico di Milano, Milano, Italy

    Antonio Pedotti

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Aliverti, A., Pennati, F., Salito, C. (2014). Computed Tomography (CT)–Based Analysis of Regional Lung Ventilation. In: Aliverti, A., Pedotti, A. (eds) Mechanics of Breathing. Springer, Milano. https://doi.org/10.1007/978-88-470-5647-3_15

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  • DOI: https://doi.org/10.1007/978-88-470-5647-3_15

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