The volume of lung parenchyma as a function of age: a review of 1050 normal CT scans of the chest with three-dimensional volumetric reconstruction of the pulmonary system.

Abstract

An Institutional Review Board-approved retrospective review of 3400 sequential CT scans of the thorax obtained at a single institution over a 3-year period from 2000 to 2003 was performed. We determined values for the volume of the right lung, left lung, and total lung volume and plot these data as a function of age and sex. To our knowledge, no normative data on CT determined lung volume as a function of age have been published. All examinations with a report of a normal CT scan of the chest (1050 examinations) were identified. The volume of lung parenchyma in each normal examination was determined by performing a three-dimensional reconstruction of the pulmonary system. Predicted increases in pulmonary volume with age for the third to 97th percentiles of male and female children were calculated. Normal values for the volume of lung parenchyma as a function of age and sex increase the clinical utility of a standard CT scan of the thorax in evaluating children with complex spinal deformities. They are a useful adjunct to pulmonary function testing. These data can be used in the pre- and postoperative evaluation of patients who are at risk of thoracic insufficiency syndrome, particularly in patients younger than 5 years of age, when standard pulmonary function testing cannot be accomplished. The effects of nonoperative treatment, early spinal fusion, and new techniques for the fusionless management of spinal deformity on lung volume can be quantified and compared to normal values.