Topography of pulmonary structure and function in man using positron emission tomography (PET) with special reference to methodology and normal physiology.

摘要

Positron emission tomography (PET) allows regional quantification of specific tracer compounds to be made within a tomographic slice of the body. The present thesis which is methodological and descriptive, centers on in vivo measurements of regional lung compartments (gas, red cells, plasma and extravascular tissue) and ventilation and blood flow in normal subjects. A method of measuring regional lung hematocrit (rH) was developed and rH was found to be found to be 90% of the peripheral hematocrit in normal subjects. No significant regional variations within the lung fields were found in normal subjects or in patients with anemia or pneumonia, which enables the pulmonary whole blood volume to be regionally quantified using a single vascular tracer. This allowed a deeper examination of the interrelationship between the different lung compartments and their variation in the gravity dependent axis and during hyperinflation. Smokers were found to have higher extravascular density than non-smokers. By combining measurement of ventilation and (sup .)V(sub A)/(sup .)Q, methods were developed to 1. correct the measured (sup .)V(sub A)/(sup .)Q for incomplete equilibrium of (sup 13)N within the alveolar space. 2. calculate regional pulmonary perfusion. By further combining these measurements with measurements of vascular and extravascular lung volumes 1. relationship between ventilation and vascular and extravascular volumes were explored and found to be consistent with the theory that ventilation is determined by the elastic properties of lung tissue and 2. relationships between blood flow and blood volume (transit times) were investigated. We conclude that blood volume plays a significant role in the matching of ventilation and perfusion and that blood flow is fairly well matched by blood volumes, thus reducing the gravitational impact on capillary transit time and hematocrit ratio which might be of rheological importance. (au). (Atomindex citation 24:032969)