Roentgenologic, physiologic and structural estimations of the total lung capacity in normal and emphysematous subjects

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      The results of a previously described roentgenologic method for estimating total lung capacity are compared to those obtained using a conventional closed circuit helium method and the body plethysmograph method in twenty normal subjects and twenty patients with chronic pulmonary emphysema. In normal subjects, no significant difference was found in the total lung capacity among the three methods. In the emphysematous patients, the values for total lung capacity obtained by the roentgenographic and plethysmographic methods were the same but were significantly greater than those obtained by the helium dilution method and the predicted normal value. In sixty-six deceased subjects the total lung capacity, as determined with the roentgenographic method, correctly predicted the absence of emphysema in nineteen and showed a good correlation with the severity of anatomic emphysema in the remaining forty-seven. It is concluded that the roentgenologic method of estimating total lung capacity described by Barnhard et al. [19] is as accurate in normal and emphysematous subjects as the best physiological methods currently in use. Because it can be carried out simply, rapidly and inexpensively, it is recommended for office and hospital use and in large scale screening studies for pulmonary emphysema.
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        • Hurtado A.
        • Kaltreider N.L.
        • Fray W.W.
        • Brooks W.D.W.
        • McCann W.S.
        Studies of total pulmonary capacity and its subdivisions. VI. Observations on cases of obstructive pulmonary emphysema.
        J. Clin. Invest. 1934; 13: 1027
        • Baldwin F.
        • Cournand A.
        • Richards Jr., D.W.
        Pulmonary insufficiency. III. A study of 122 cases of chronic pulmonary emphysema.
        Medicine. 1949; 28: 201
        • Renzetti Jr., A.D.
        • Eastman G.
        • Auchincloss Jr., J.H.
        • Gilbert R.
        • Eich R.
        • Dutton R.
        Physiologic defects in chronic bronchitis.
        Am. Rev. Tuberc. 1958; 78: 191
        • Ogilvie C.
        Patterns of disturbed lung function in patients with chronic obstructive vesicular emphysema.
        Thorax. 1959; 14: 113
        • Burrows B.
        • Niden A.H.
        • Fletcher C.M.
        • Jones N.L.
        Clinical types of chronic obstructive lung disease in London and in Chicago.
        Am. Rev. Resp. Dis. 1964; 90: 14
        • Emmanuel G.
        • Briscoe W.A.
        • Cournand A.
        A method for the determination of the volume of air in the lungs. Measurements in chronic pulmonary emphysema.
        J. Clin. Invest. 1961; 40: 329
        • Blair E.
        • Hickam J.B.
        Quantitative studies of intrapulmonary gas mixing in emphysema.
        Am. J. Med. 1955; 18: 519
        • Tierney D.F.
        • Nadel J.A.
        Concurrent measurements of functional residual capacity by three methods.
        J. Appl. Physiol. 1962; 17: 871
        • Bedell G.N.
        • Marshall R.
        • DuBois A.B.
        • Comroe Jr., J.H.
        Plethysmographic determination of the volume of gas trapped in the lungs.
        J. Clin. Invest. 1956; 35: 664
        • Ross J.C.
        • Copher D.E.
        • Teays J.D.
        • Lord T.J.
        Functional residual capacity in patients with pulmonary emphysema.
        Ann. Int. Med. 1962; 57: 18
        • Hurtado A.
        • Fray W.W.
        Studies of total pulmonary capacity and its subdivisions. II. Correlation with physical and radiological measurements.
        J. Clin. Invest. 1933; 12: 807
        • Whitfield A.G.W.
        • Smith O.E.
        • Richards D.B.G.
        • Waterhouse J.A.H.
        • Arnott W.M.
        The correlation between the radiological appearances and the clinical and spirometric state in emphysema.
        Quart. J. Med. 1951; 79: 247
        • Kaltreider N.L.
        • Fray W.W.
        • Hyde H.V.Z.
        The effect of age on the total pulmonary capacity and its subdivisions.
        Am. Rev. Tuberc. 1938; 37: 663
        • Aslett E.A.
        • Hart P.D.A.
        • McMichael J.
        The lung volume and its subdivisions in normal males.
        in: 11th ed. Proc. Roy. Soc. London, s.B.126. 1938: 502
        • Gilson J.C.
        • Hugh-Jones P.
        The measurement of the total lung volume and breathing capacity.
        Clin. Sc. 1949; 7: 185
        • Ward O.L.
        • Gilson J.C.
        The effect of posture on diaphragmatic movement and vital capacity in normal subjects with a note on spirometry as an aid in determining radiologic chest volumes.
        Thorax. 1951; 6: 103
        • Cobb S.
        • Blodgett D.J.
        • Olson K.B.
        • Stranahan A.
        Determination of total lung capacity in disease from routine chest roentgenograms.
        Am. J. Med. 1954; 16: 39
        • Kovach J.C.
        • Avedian V.
        • Morales G.
        • Pouos P.
        Lung compartment determination.
        J. Thoracic Surg. 1956; 31: 452
        • Barnhard H.J.
        • Pierce J.A.
        • Joyce J.W.
        • Bates J.H.
        Roentgenographic determination of total lung capacity.
        Am. J. Med. 1960; 28: 51
        • Nicklaus T.M.
        • Stowell D.W.
        • Christiansen W.R.
        • Renzetti Jr., A.D.
        The accuracy of the radiological diagnosis of chronic pulmonary emphysema.
        Am. Rev. of Resp. Dis. 1966; 93: 889
      1. Bernstein, L. and Shepard, R. H. Personal communication.

        • DuBois A.B.
        • Botelho S.Y.
        • Comroe Jr., J.H.
        A rapid plethysmographic method for measuring thoracic gas volume. A comparison with a nitrogen washout method for measuring functional residual capacity in normal subjects.
        J. Clin. Invest. 1956; 35: 322
        • Schmidt A.H.
        • Cohn J.E.
        Modified body plethysmograph for study of cardiopulmonary physiology.
        J. Appl. Physiol. 1961; 16: 935
        • Gough J.
        • Wentworth J.E.
        Thin sections of entire organs mounted on paper.
        J. Roy. Micr. Soc. 1949; 69: 231
        • Cromie J.B.
        Correlation of anatomic pulmonary emphysema and right ventricular hypertrophy.
        Am. Rev. Resp. Dis. 1961; 84: 657
        • Watanabe S.
        • Mitchell M.
        • Renzetti Jr., A.D.
        Correlation of structure and function in chronic pulmonary emphysema.
        Am. Rev. Resp. Dis. 1965; 92: 221
        • Boren H.G.
        • Kory R.C.
        • Syner J.C.
        The Veterans Administration-Army Cooperative Study of Pulmonary Function. II. The lung volume and its subdivisions in normal men.
        Am. J. Med. 1966; 41: 96
        • Sweet H.C.
        • Wyatt J.P.
        • Kinsella P.W.
        Correlation of lung macrosections with pulmonary function in emphysema.
        Am. J. Med. 1960; 29: 277
        • Wyatt J.P.
        • Fischer V.W.
        • Sweet H.G.
        Panlobular emphysema: anatomy and pathodynamics.
        Dis. Chest. 1962; 41: 239