Blood circulation in the lungs: radiologic methods of diagnosing microcirculation changes in the small circle of circulation
https://doi.org/10.24884/1682-6655-2019-18-1-5-16
Abstract
Radiological diagnosis of diseases of the respiratory system includes a number of methods based on various ways of obtaining information about the state of the chest organs. Most of the applied methods are aimed at identifying structural changes in the lung parenchyma, however, with the development of lung diseases, the pathological process affects all anatomical structures of the lungs, without exception, including the vascular bed of the lungs, primarily due to its microcirculatory level, therefore, this process requires special attention of specialists to the methods detecting changes in the pulmonary microvasculature. Depending on the purposes of the study, various methods of radiologic diagnosis should be used in combination. The review provides a brief anatomical characteristic of the capillary bed of the lungs. History of the study of blood circulation in a small circle is discussed, and modern methods of radiologic research are used to detect lung diseases.
About the Authors
V. I. Amosov
Academician I. P. Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
Amosov Viktor I. – MD, professor of radiology and radiation medicine department
197022, Saint-Petersburg, L’va Tolstogo street, 6-8
V. Р. Zolotnitskaia
Academician I. P. Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
Zolotnitskaia Valentina P. – PhD, Senior Scientific Researcher and Scientific Institute of Pulmonology
197022, Saint-Petersburg, L’va Tolstogo street, 6-8
References
1. Garvej V. Anatomical study of the movement of the heart and blood of animals. USSR Academy of Sciences. 1948:236. (In Russ.).
2. Izakson Je. About the patho-anatomical changes of the pulmonary vessels during emphysematous process in the lungs: Thesis for the degree of doctor of medicine. SPb., 1870. Isakson E. On the pathoanatomical changes of the pulmonary vessels during emphysematous process in the lungs: Dis ... Dr. med. SPb., 1870. Pul’monologija. 2005;4:42–52. (In Russ.).
3. Physiology and pathophysiology of the pulmonary vessels / ed. E. I. Weir, J. T. Reeves (translated from English). M., Medicine, 1995:672. (In Russ.).
4. Dvoretsky DP. Physiological assessment of arterio-venous anastomoses in the pulmonary circulation. Fiziol. zhurn. THE USSR. 1973;59(2):299–306. (In Russ.).
5. Dvoretsky DP, Tkachenko BI. Hemodynamics in the lungs. M., Medicine, 1987:288. (In Russ.).
6. Wagenvoort CA, Wagenvoort N. Arterial anastomoses, bronchopulmonary arteries and pulmobronchial arteries in perinatal lungs. Lab. Invest. 1967;16:13–14. Doi: 10.1016/s0046-8177(85)80281-1.
7. Karo K, Pedley T, Schrother R, Sid U. Circulatory Mechanics. Publishing house «MIR» Moscow. 1981:624. (In Russ.).
8. Bisenkov NP. Anatomical and physiological substantiation of surgical interventions on the lungs and organs of the prostate, Breast surgery. 1963;5:24–26. (In Russ.)]
9. Reid L. Structural and functional reappraisal of the pulmonary artery system. In Scientifc Basis of Medicine Annual Reviews. London: Athlone, 1968:289–307. Doi: 10.1002/bjs.1800551026.
10. Респираторная медицина: руководство: в 3 т. / под ред. А. Г. Чучалина. – М.: ГЭОТАРМедиа, 2017. (In Russ.). URL: http://www.rosmedlib.ru/book/ISBN9785423502621.html (дата обращения 12.02.2019).
11. West DB. Pathophysiology of the respiratory system. Per. from English Edited by AI. Sinopalnikov. M., BINOM, 2008:232. (In Russ.).
12. Shershevsky BM. Blood circulation in a small circle. M., Medicine, 1970:304. (In Russ.).
13. Glazier JB, Hughes JMB, Maloney JE, West JB. Measurements of capillary dimensions and blood volume in rapidly frozen lungs. J Appl Physiol. 1969. 26:65–76. Doi: 10.1152/jappl.1969.26.1.65.
14. Gil J. Organization of the microcirculation of the lung. Annu Rev Physiol. 1980;42:177–186. Doi: 10.1146/annurev.ph.42.030180.001141.
15. Vasilyev GF. Respiratory system. European journal of biomedical and life sciences. 2015;3:101–107. Doi:org/10/20534/elbis-15-3-101-107.
16. West JB. Ventilation-perfusion relationships. Amer. Rev. resp. Dis. 1977;116(5):919–943. Doi: 10.1016/s0140-6736(63)90024-2.
17. West JB. Ventilation/Blood Flow and Gas Exchange (5th ed). Oxford: Blackwell Scientifc, 1990;1–120. Doi: 10.1056/nejm199107253250420.
18. Wagner PD, Laravuso RB, Uhl RR, West JB. Continuous distributions of ventilation-perfusion ratios in normal subjects breathing air and 100% O2. J Clin Invest. 1974.54:54–68. Doi: 10.1172/jci107750.
19. Gaides MA. Regulation of ventilation and perfusion of the lungs. Available at: http://www.medlinks.ru/article.php.sid=26509 (accessed 12.02.2019).
20. Hanania NA, Marciniuk DD. A Unifed Front Against COPD: Clinical Practice Guidelines From the American College of Physicians, the American College of Chest Physicians, the American Thoracic Society, and the European Respiratory Society. Chest. 2011;140(3):565–566. Doi: 10.1378/.11-1152.
21. Tyurin IE. Computed tomography of the chest cavity organs. SPb., ELBI-SPb., 2003:371. (In Russ.).
22. Kim S, Kamaya A, Willmann J. CT Perfusion of the Liver: Principles and Applications in Oncology. Radiology. 2014;272(2):322–344. Diu: 10.1148/radiol.14130091.
23. Axel L. Cerebral blood flow determination by rapidsequence computed tomography: theoretical analysis. Radiology. 1980;137(3):679–686. Doi: 10.1148/radiology.137.3.7003648.
24. Ng C, Chandler A, Wei W, Anderson E, Herron D, Charnsangavej C, Kurzrock R. Reproducibility of Perfusion Parameters Obtained From Perfusion CT in Lung Tumors. American Journal of Roentgenology. 2011;197(1):113–121. Doi: 10.2214/ajr.10.5404.
25. Silanteva NK, Petrosian AP, Kaprin AD, Ivanov SA, Usacheva AYu, Mozerov SA, Kupriyanova EI. Differential diagnosis of solitary pulmonary nodule: what does ct-perfusion give? Russian electronic journal of radiology. 2018;8(4):83–94. (In Russ.). Doi: 10.21569/2222-7415-2018-8-4-83-94.
26. Taplin GV, Johnson DE, Dore EK. Lung photoscans with macroaggregates of human serum radioalbumin: experimental basis and initial clinical trials. Health Phys. 1964;10:1219– 1227. Doi: 10.1097/00004032-196412000-00043.
27. Bogolyubov VM. Radioisotope diagnosis of diseases of the heart and lungs. M., Meditsina, 1975:256. (In Russ.).
28. Korsunsky VN, Romagin VK. Radionuclide studies of the lungs / Standardized radioisotope diagnostic techniques. Obninsk, 1987:220–229. (In Russ.).
29. Lishmanov YuB, Krivonogov NG, Zavadovsky KV. Radionuclide diagnosis of pathology of the pulmonary circulation. Tomsk, STT, 2004:204. (In Russ.).
30. National guidelines for radionuclide diagnostics in 2 tons. [Ed. YuB Lishmanova, VI Chernov]. Tomsk, STT, 2010. T. 2:418. (In Russ.).
31. Lishmanov YuB, Krivonogov NG, Ageeva AV, Dubodelova TS. Radionuclide assessment of alveolar-capillary permeability for early recognition of the nosological origin of infltrate in the lung. Pulmonology. 2011;4:60–64. (In Russ.).
32. Rubin MP, Kuleshov OD, Chechurin R.Ye. Radionuclide perfusion lung scintigraphy: methods of research and interpretation of results. Radiology practice. 2002;4:16–21. (In Russ.).
33. Rubin MP. Radionuclide methods for the diagnosis of functional disorders of the lungs in the outpatient setting. Therapeutic archive. 2008;1:10–16. (In Russ.).
34. Gabunia RI. Perfusion and inhalation pulmonoscintigraphy. Clinical X-ray Radiology. M., Medicine, 1985:85–93. (In Russ.).
35. Bondar VG, Khelimskaya IV. Modern methods of microcirculation assessment in smokers and patients with chronic obstructive pulmonary disease. Directory of general practitioner. 2016;2:32–39. (In Russ.).
36. Zavadovsky KV, Pankova A.N., Krivonogov NG, Lishmanov YuB. Radionuclide diagnosis of pulmonary embolism: visualization of perfusion and ventilation of the right ventricular contractility. SMZH. 2011;2–1. (In Russ.).
37. Bajc M., Neilly JB, Miniati M. EANM guidelines for ventilation/perfusion scintigraphy. Eur. J. Nucl. Med. Mol. Imaging. 2009;36:1356–370. Doi: 10.1007/s00259-009-1170-5.
38. Amosov VI, Zolotnitskaya VP, Lukina OV, Speranskaya AA. Combined technologies in the diagnosis of vascular pathology. Scientifc notes SPbGMU them. Acad. I. P. Pavlova. 2009;16(3):26–27. (In Russ.).
39. Amosov I, Zolotnitskaya VP, Lukina OV. Radiation techniques in the diagnosis of complications of chronic obstructive pulmonary disease. Tracheal diagnosis and therapy. 2010;3 (2):37–39. (In Russ.).
40. Gorbunov NA, Laptev VYa, Kochura VI. Features of radiation diagnosis of chronic obstructive pulmonary disease at the present stage. Radiology and therapy. 2011;4(2):33–39. (In Russ.).
41. Gorbunov NA, Dergilev AP, Sidorova LD. Radiological diagnosis of exacerbations of chronic obstructive pulmonary disease. Bulletin of the East-Siberian Scientifc Center of the Russian Academy of Medical Sciences. 2014;1(95):102–111. (In Russ.).
42. Suga K, Kawakami Y, Iwanaga H. Automated breathhold perfusion SPECT/CT fusion images of the lungs. Am. J. Roentgenol. 2007;189(2):455–463. Doi: 10.2214/ajr.06.1290.
43. Hasegava B. SPECT and SPECT – CT. 92-nd Scientifc assembly and annual meeting Radiologic Society of North America. 2006:171. Doi: 10.3109/9781420016468-14.
44. Tyurin EI, Amosov VI, Amoashy GS. Radiological diagnosis of bronchial obstruction. Herald of radiology and radiology. 1992;1:18. (In Russ.).
45. Tyurin IE. Imaging methods for chronic obstructive pulmonary disease / Chronic obstructive pulmonary disease: monograph / Under. ed. Chuchalina AG. M., Atmosphere, 2008:231–264. (In Russ.).
46. Tyurin IE. Visualization of chronic obstructive pulmonary disease. Practical pulmonology. 2014;2:40–47. (In Russ.).
47. Amosov VI, Zolotnitskaya VP, Lukina OV, Kuzubova NA, Osipov NP. Microcirculatory dysfunctions in patients with chronic obstructive pulmonary disease. Regional blood circulation and microcirculation. 2005;4(3):41–45. (In Russ.).
48. Zolotnitskaya VP, Lukina OV. The value of radiation diagnosis in the study of pulmonary perfusion in patients with COPD. Regional blood circulation and microcirculation. 2007;6(3):34–38. (In Russ.).
49. Carlos H, Chen Y-H, Westgate PhM. COPD Gene Investigators Relationship between quantitative CT metricsand health status and BODE in chronic obstructive pulmonary disease Thorax. 2012;67:399–406. Doi: 10.1136/thoraxjnl-2011-201185.
50. Karoli NA, Rebrov AP. Mortality in chronic obstructive pulmonary disease. The role of comorbidity. Clinical medicine. 2006;7:397–412. (In Russ.).
51. Kudryashova NYe, Yermolov AS, Migunova EV, Sinyakova OG, Gurok EA. Scintigraphy in urgent conditions and complications of acute diseases and traumas. Sklifosovsky research Institute for Emergency Medicine. 2014;2:14–19. (In Russ.). Doi: 10.23934/2223-9022-2017-6-2-118-123.
52. Lukina OV. Radiological diagnosis of pulmonary thromboembolism in patients with emphysematous phenotype chronic obstructive pulmonary disease. Regional blood circulation and microcirculation. 2013;12(1):34–38. (In Russ.).
53. Akramova EG. Problems of diagnosis of comorbid forms of chronic obstructive pulmonary disease. Scientifc Review. Medical sciences. 2016;3:5–22. (In Russ.). Doi: 10.17750/kmj2015-496.
54. Fishman A, Martinez F, Naunheim K. A randomized trial comparing lung-volume-reduction surgery with medical therapy for severe emphysema. N. Engl. J. Med. 2003;348:2059–2073. Doi: 10.1056/nejmoa030287.
55. Mohamed Hoesein FA, de Jong PA. Landmark papers in respiratory medicine: Automatic quantifcation of emphysema and airways disease on computed tomography. Breathe. 2016;12(1): 79–81. Doi: 10.1183/20734735.013415.
56. Calverley PM, Martinez FJ, Fabbri LM. Does roflumilast decrease exacerbations in severe COPD patients not controlled by inhaled combination therapy? The REACT study protocol. Int. J. Chron. Obstruct. Pulmon. Dis. 2012;7:375– 382. Doi: 10.2147/copd.s31100.
57. Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur. Respir. J. 2004;23(6):932–946. Doi: 10.1183/09031936.04.00014304.
58. Voelkel NF, Cool CD. Pulmonary vascular involvement in chronic obstructive pulmonary disease. Eur. Respi. J. Suppl. 2003;46(11):28–32. Doi: 10.1183/09031936.03.00000503.
59. Zakynthinos E, Daniil Z, Papanikolaou G, Makris D. Pulmonary Hypertension in COPD: Pathophysiology and Therapeutic Targets Drug Targets. 2011. Jan 3. [Epub ahead of print] PMID.-е. 21194405. Doi: 10.2174/138945011794751483.
60. Kuzubova NA, Gichkin AYu, Surkova EA, Titova ON. The role of systemic inflammation and endothelial dysfunction in the development of left ventricular failure in patients with chronic obstructive pulmonary disease. Pulmonology 2013;4(4):41– 45. (In Russ.). Doi: /10.18093/0869-0189-2013-0-4-41-45.
61. Neklyudova GV, Chernyaev AL, Chernyak AV, Samsonova MV, Tarasenko IYu, Bykanova AV, Naumenko ZhK. Morphofunctional changes in the vessels of the pulmonary artery system in secondary pulmonary hypertension caused by COPD. Pulmonology. 2006;4:21–25. (In Russ.).
62. Shmelev EI. Strategic aspects of the treatment of patients with chronic obstructive pulmonary disease. Therapeutic archive. 2011; 83(8):5–10. (In Russ.).
63. Amosov VI, Speranskaya AA, Zolotnitskaya VP. The possibilities of radiation diagnosis in the assessment of vascular disorders in patients with disseminated processes in the lungs. Russian Electronic Journal of Radiology. 2011;1(2):36–46. (In Russ.).
64. Wiesel AA, Wiesel IYu. Sarcoidosis: international consensus documents and recommendations. Russian medical journal. 2014;5:356–360. (In Russ.).
65. Baranova O, Perley V, Gichkin A, Zolotnitskaya V, Speranskaya A, Ilkovich M. Features of diagnosis and course of pulmonary embolism in patients with sarcoidosis of the respiratory organs. Doctor. 2012;2:82–88. (In Russ.).
66. Baranova OP, Novikova LN, Speranskaya AA, Zolotnitskaya VP, Perley VE, Gichkin AYu. Diffculties in the diagnosis of pulmonary thromboembolism (PE) in patients with interstitial lung diseases. Ulyanovsk Biomedical Journal. 2016;S4:16–18. (In Russ.).
67. Disseminated pulmonary diseases / Edited by MM Ilkovich. M., GEOTAR-Media, 2011:480. (In Russ.).
68. Akopov AL, Baranova OP, Bogdanov AN. Interstitial and orphan diseases of the lungs / ed. M. M. Ilkovich. M., 2016:115–120. (In Russ.).
69. Handa T, Nagai S, Hirai T. Computed tomography analysis of airway dimensions and lung density in patients with sarcoidosis. Respiration. 2009;77:273–281. Doi: 10.1159/000151544.
70. Zolotnitskaya VP, Amosov VI, Dzadzua DV. Features of violations of microcirculation in the lungs in patients with histiocytosis X with different variants of dysfunction of externalrespiration. Regional blood circulation and microcirculation. 2016;3(59):30–35. (In Russ.). Doi: org/10.24884/1682-6655-2016-15-3-30-35.
71. Gavrisyuk VK., Strafun OV, Shadrina OV. Rare interstitial lung diseases: Langerhans cell lung histiocytosis. Health of Ukraine. May 14, 2012:32–34.
72. Speranskaya AA. MDST-Angiography and SPECT in assessing the causes of the unfavorable course of rare interstitial lung diseases (lymphangioleiomyomatosis, histiocytosis X). Regional blood circulation and microcirculation. 2013;1(45):58–64. Doi: 10.1378/1682-6655-2013-15-1.
73. Tazi A. Adult Pulmonary Langerhans’cell histiocytosis. Eur. Respir. J. 2006;27:1272–1285. Doi: 10.1183/09031936.06.00024004.
74. Tazi A, Marc K, Dominique S et al. Serial computed tomography and lung function testing in pulmonary Langerhans’ cell histiocytosis. Eur Respir J. 2012;40:905–912. Doi: 10.1183/09031936.00210711.
75. Vassallo R, Ryu JH, Colby TV. Pulmonary Langerhans’cell histiocytosis R. N. Engl. J. Med. 2000;342:1969–1978. Doi: 10.1056/NEJM200006293422607.
76. Orlova GP. Problems of classifcation of occupational interstitial lung diseases, approaches to the solution. Labor Medicine and Industrial Ecology. 2013;8:27–29. (In Russ.).
77. Vlakhov N, Teshev G. Perfusion pulmonary scintigraphy for cancer and some non-neoplastic lung diseases. Med. radiol. 1983;28(1):77–76. (In Russ.).
78. Chernehovskaya NE, Vyrenkova NYu. Comparison of the results of X-ray, endoscopic and radionuclide studies in deforming bronchitis. Medical radiology. 1989;3:48–59. (In Russ.).
79. Early stages of silicosis / M. V. Evgenova [et al.].; ed. K. P. Molokanov; Academy of Medical Sciences of the USSR. L., Medicine, 1968:219. (In Russ.).
80. Vagina ER, Likhacheva EI. Some mechanisms of genesis of ventilation and hemodynamic disorders in asbestosis and thalcosis. Occupational diseases of dust etiology: Collection of scientifc papers. M., Institute of Hygiene them. F. F. Erisman, 1986:37–41. (In Russ.).
81. Zolotnitskaya VP, Kuzubova NA, Titova ON, Surkova EA, Shumilov AA. Possibilities of correcting capillary blood circulation in the lungs in patients with chronic obstructive pulmonary disease with a combined pathology. Pulmonology. 2017;27(6):767–775. (In Russ.). Doi: org/10.18093/0869-0189-2017-27-6-767-775.
Review
For citations:
Amosov V.I., Zolotnitskaia V.Р. Blood circulation in the lungs: radiologic methods of diagnosing microcirculation changes in the small circle of circulation. Regional blood circulation and microcirculation. 2019;18(1):5-16. (In Russ.) https://doi.org/10.24884/1682-6655-2019-18-1-5-16
Views:
2564
Email this article 
