Investigating the potential to assess severe lung inhalation injuries using computed tomography

• Published in: Burns Vol. 45; no. 2; pp. 310 - 316
• Main Authors: Zhan, Qiu, Cui, Pei, Pan, Yuchen, Dai, Zheng, Gong, Zhenyu, Xin, Haiming, Tang, Fang, Deng, Chunjiang, Huang, Gaoxiang, Zhu, Fujun, Tong, Yalin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-03-2019
• Subjects: Animals; Burns, Inhalation - diagnostic imaging; Burns, Inhalation - pathology; CT scan; Hemorrhage - pathology; Inflammation - pathology; Lung - diagnostic imaging; Lung - pathology; Pathological score; Pulmonary Edema - pathology; Rabbits; Severe inhalation injury; Steam; Tomography, X-Ray Computed; Trauma Severity Indices; Wet/dry weight; Severe inhalation injury; CT; Pathological score; RADS; Wet/dry weight; W/D; CT scan; ARDS
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2018.11.012

•RADS was consistent with the pathological scores in severe lung inhalation injury.•RADS was consistent with W/D ratio in severe lung inhalation injury of rabbits.•CT scan relatively accurately reflects severe lung inhalation injuries.•CT scan has the potential to assess severe lung inhalation injuries.
The purpose of this study is to investigate the potential use of computed tomography (CT) in assessing inhalation injuries at various levels by studying the changes in lung imaging of rabbits with severe inhalation injury.
The sham, serious, critical, and extremely critical lung inhalation injury models were established by the New Zealand white rabbits’ inhalation of steam for 0s, 0.25s, 0.50s, and 1.00s, respectively. Lung CT scans were performed at 1, 4, and 12h after the administration of steam and a radiologist’s scores (RADS) were collected for each CT scan. Lung tissues were later collected to measure the lung wet/dry weight (W/D) ratio and to determine pathological scores. The correlation of the RADS with the lung-tissue pathological scores and W/D changes was investigated.
The RADS and lung-tissue pathological scores are dependent on the time after injury and the level of injury. W/D ratios are dependent on the level of injury. The W/D ratio showed an increasing trend from 1h to 4h for the 0.25s, 0.50s, and 1s inhalation injury groups, while the W/D ratio decreased from 4h to 12h for the 0.25s and 0.50s inhalation injury groups. Further analysis indicates that, at the same time point, the lung RADS positively correlates with both the lung pathological scores and W/D ratios.
A lung CT scan is able to reflect the early-stage lung injuries of rabbits with different levels of severe inhalation injury.