In this paper we propose a new method based

In this paper we propose a new method based on objective measurements to describe emphysema according to CT in patients who are candidates

LVRS. The method allows to surgically oriented classification in categories that markedly heterogeneous emphysema

, moderately heterogeneous emphysema, emphysema and uniform taken from buckets etc.

installation of the upper or lower proportion of the prevalence and comparison of left and right lung . Over the past few years, LVRS has received great interest as a palliative treatment in patients with severe pulmonary emphysema >>. << Results of many studies have shown symptomatic and functional improvement after this procedure. Despite the documented

improvements in average physiological values ​​after the procedure, unclear why some patients have significant >> << improve their basic clinical symptoms as a result of LVRS, while others do not. This may be a reflection of a heterogeneous population of patients >> <<, differences in selection criteria, different surgical techniques, or change in the description of emphysema can be

factor. There is no consensus on the radiological classification of emphysema morphology. System reassessment and moderate

interobserver agreement could lead to violations of subjective visual grading of emphysema. Therefore, objective methods should be better to achieve precise, reader independent quantitative emphysema. Many authors claim that heterogeneity is one of the best harbingers of improvement. This may be correct. However, some surgeons operate on patients with homogeneous emphysema, and advise the postoperative improvement

This group of patients. Questions BЂњWhat is uneven distribution of emphysema? BЂ "noted an editorial in Austin. also emphasized the problem in the last edition. Because the methodology for the assessment of heterogeneity in emphysema, a description of results

changing. For example, Wisser and others

used the term homogeneous emphysema, unlike the term bullous emphysema, while others use it for emphysema without heterogeneity. comparison evaluation of heterogeneity of 0 to 4 in one area with those in another, while others >> << compared the differences in the area

for example, heavily damaged areas of the region of light emphysema. In addition, comparison of differences in the degree of emphysema among

adjacent segments was used. Various quantitative CT measurements were also used, since the rate of SD medium light weakening

for more complex mathematical models. In this study, to model for classification of emphysema heterogeneity offered. Our model not only

objectively calculated, but also due to the surgically relevant morphologic types of emphysema and allows the department

left and right lung, and upper and lower lobes with a predominance of emphysema. Despite the detection of lasix 60 mg iv different types of emphysema morphology

left and right lung is common (

) in this group of patients is, as far as we know, are not reported in the study of postoperative outcome. We do not know whether they are

accepted for unilateral LVRS or they will be rejected. One problem in this study was the lack BЂњgold standardBЂ "of emphysema heterogeneity. We decided to develop our classification

model in two stages: first, a model based on 45 patients, and evaluate the classification for more

21 patients. The intention with our method is to create a model applicable in clinical practice. The only necessary equipment >> << this software for the quantitative measurement of CT and linear regression analysis. Type CT unit, the algorithm, the thickness of cut, the software for measuring EI, and the threshold for EI, which are used, however, >> << are important factors that affect both the slope, K, E, and therefore, classification. Each investigator must establish, in accordance with their terms, their level and to EI difference. Definitions >> << K and EI difference for the three types of emphysema heterogeneity in this study may be valid only for

, combination of these factors in our study. Thus, the model should be considered as a method in principle. The purpose of the classification of emphysema distribution presented here may or may facilitate the selection of patients for LVRS,

and comparison between different studies. The final value of our model in the selection of patients and correlation with postoperative results

still not proven. . << >>