Original Articles| Volume 32, ISSUE 5, P346-354, September 2008

Traumatic pulmonary pathology measured with computed tomography and a semiautomated analytic method


      The goal of this study is to develop a controlled approach to quantifying the amount of lung damage after blunt chest trauma. The presented method is used to analyze computed tomography scans and to assess patients' risk for developing acute respiratory distress syndrome (ARDS). When used to predict which patients were at risk for ARDS, the method presented in this study had a sensitivity of 57% and a specificity of 100%.


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        • Miller PR
        • Croce MA
        • Bee TK
        • et al.
        ARDS after pulmonary contusion: accurate measurement of contusion volume identifies high-risk patients.
        J Trauma. 2001; 51 ([discussion 229–30]): 223-228
        • Klein Y
        • Cohn SM
        • Proctor KG
        Lung contusion: pathophysiology and management.
        Curr Opin Anaesthesiol. 2002; 15: 65-68
        • Cohn SM
        Pulmonary contusion: review of the clinical entity.
        J Trauma Inj Infect Crit Care. 1997; 42: 973-979
        • Duggan M
        • Kavanagh BP
        Pulmonary atelectasis: a pathogenic perioperative entity.
        Anesthesiology. 2005; 102: 838-854
        • Reske A
        • Seiwerts M
        • Reske A
        • Gottschaldt U
        • Schreiter D
        Early recovery from post-traumatic acute respiratory distress syndrome.
        Clin Physiol Funct Imaging. 2006; 26: 376-379
        • Trupka A
        • Waydhas C
        • Hallfeldt KK
        • Nast-Kolb D
        • Pfeifer KJ
        • Schweiberer L
        Value of thoracic computed tomography in the first assessment of severely injured patients with blunt chest trauma: results of a prospective study.
        J Trauma. 1997; 43 ([discussion 411–02]): 405-411
        • Mizushima Y
        • Hiraide A
        • Shimazu T
        • Yoshioka T
        • Sugimoto H
        Changes in contused lung volume and oxygenation in patients with pulmonary parenchymal injury after blunt chest trauma.
        Am J Emerg Med. 2000; 18: 385-389
        • Sluimer I
        • Prokop M
        • van Ginneken B
        Toward automated segmentation of the pathological lung in CT.
        IEEE Trans Med Imaging. 2005; 24: 1025-1038
        • Leader JK
        • Zheng B
        • Rogers RM
        • et al.
        Automated lung segmentation in X-ray computed tomography: development and evaluation of a heuristic threshold-based scheme.
        Acad Radiol. 2003; 10: 1224-1236
        • Brown MS
        • McNitt-Gray MF
        • Goldin JG
        • et al.
        Automated measurement of single and total lung volume from CT.
        J Comput Assist Tomogr. 1999; 23: 632-640
        • Sakai N
        • Mishima M
        • Nishimura K
        • Itoh H
        • Kuno K
        An automated method to assess the distribution of low attenuation areas on chest CT scans in chronic pulmonary emphysema patients.
        Chest. 1994; 106: 1319-1325
        • Misra A
        • Rudrapatna M
        • Sowmya A
        Automatic lung segmentation: a comparison of anatomical and machine learning approaches.
        in: Palaniswami M Krishnamachari B Sowmya A Challa S Proceedings of the 2004 Intelligent Sensors, Sensor Networks and Information Processing Conference. IEEE Computer Society, Piscataway, NJ2004: 451-456
        • Ukil S
        • Reinhardt JM
        Smoothing lung segmentation surfaces in three-dimensional X-ray CT images using anatomic guidance.
        Acad Radiol. 2005; 12: 1502-1511
        • Wagner RB
        • Crawford WO
        • Schimpf PP
        Classification of parenchymal injuries of the lung.
        Radiology. 1988; 167: 77-82
        • Lu Q
        • Constantin JM
        • Nieszkowska A
        • Elman M
        • Vieira S
        • Rouby JJ
        Measurement of alveolar derecruitment in patients with acute lung injury: computerized tomography versus pressure–volume curve.
        Crit Care. 2006; 10: R95
        • Wagner RB
        • Jamieson PM
        Pulmonary contusion. Evaluation and classification by computed tomography.
        Surg Clin North Am. 1989; 69: 31-40
        • Chabat F
        • Yang GZ
        • Hansell DM
        Obstructive lung diseases: texture classification for differentiation at CT.
        Radiology. 2003; 228: 871-877
        • Chabat F
        • Desai SR
        • Hansell DM
        • Yang GZ
        Gradient correction and classification of CT lung images for the automated quantification of mosaic attenuation pattern.
        J Comput Assist Tomogr. 2000; 24: 437-447
        • Armato SG
        • Sensakovic WF
        Automated lung segmentation for thoracic CT impact on computer-aided diagnosis.
        Acad Radiol. 2004; 11: 1011-1021
        • Bernard GR
        • Artigas A
        • Brigham KL
        • et al.
        The American–European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination.
        Am J Respir Crit Care Med. 1994; 149: 818-824
        • Calabrese L
        Volume of human lungs.
        in: Elert G The physics factbook. 2001 (Available at:
        • Stitzel JD
        • Gayzik FS
        • Hoth JJ
        • et al.
        Development of a finite element-based injury metric for pulmonary contusion: Part I. Model development and validation.
        Stapp Car Crash J. 2005; 49: 271-289
        • Hoth JJ
        • Stitzel JD
        • Gayzik FS
        • et al.
        The pathogenesis of pulmonary contusion: an open chest model in the rat.
        J Trauma. 2006; 61 ([discussion 44–35]): 32-44