The Effects of Age, Sex, Lung Size, and Hyperinflation on CT Lung Densitometry

OBJECTIVE. To test our proposal that, on high-resolution CT scans, the relative area of the lung with attenuation values lower than -950 H (RA(950)) can be a measurement of pulmonary emphysema, we examine the possible influences of sex, age, lung size, and hyperinflation on CT lung densitometry. SUBJECTS AND METHODS. The RA(950) and the mean lung density (MLD) were measured in 42 healthy subjects (21 men, 21 women) from 23 to 71 years old, in 10 patients with asthma before and after a bronchial challenge test, and in seven patients with asthma who have irreversible hyperinflation (defined as an increased total lung capacity). RESULTS. In the healthy subjects, we found no significant difference between sexes and no significant correlation between age and the MLD, but we found a significant correlation between age and the RA(950) In addition, we found a significant correlation between the total lung capacity expressed as absolute values and both the RA(950) and the MLD. We did not observe any effect of acute airflow limitation either on the MLD or on the RA(950) in the asthmatic subjects after the bronchial challenge test. Likewise, we observed no change in either the MLD or the RA(950) in the asthmatic subjects with chronic hyperinflation. CONCLUSION. This study shows that CT lung densitometry is influenced by total lung capacity and, to a lesser degree, by age. Thus, this study suggests that normal CT attenuation values for the lung should be established.