ISSN: 1899-0967
Polish Journal of Radiology
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2019
vol. 84
 
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abstract:
Original paper

Quantitative assessment of airway and parenchymal components of chronic obstructive pulmonary disease using thin-section helical computed tomography

Narvir S. Chauhan, Dinesh Sood, Preeti Takkar, Devendra S. Dhadwal, Rajiv Kapila

© Pol J Radiol 2019; 84: e54-e60
Online publish date: 2019/01/21
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Purpose
The purpose of this study was to diagnose and characterise chronic obstructive pulmonary disease (COPD) into its forms, patterns, and severity using MDCT.

Material and methods
In this prospective study, spirometric and MDCT evaluation was done in 52 consecutive patients diagnosed with COPD. In each patient six segmental bronchi were evaluated for CT morphometric indices of bronchial wall thickness (BWT) and wall area percentage (WAP). Quantitative evaluation of emphysema was done using inbuilt software, and volume of emphysematous lung was determined using percentage low attenuation area (LAA). COPD was categorised into the following: emphysema predominant; airway predominant; or mixed phenotypes, and severity grading was assigned as mild, moderate, or severe.

Results
Centrilobular was the predominant emphysema pattern occurring alone (36.5%) or in combination with paraseptal changes (34.6%). Among COPD phenotypes, emphysema predominant was the commonest (44.3%), followed by mixed (30.8%), and bronchitis predominant (25.0%). The mean BWT in the airway-predominant group was significantly higher (1.94 ± 0.28 mm) than in the emphysema-predominant subgroup (1.79 ± 0.23 mm) with a p value of 0.005.

Conclusions
MDCT is an indispensable tool in quantitative and qualitative evaluation of COPD patients. Measurement of CT indices like BWT, WAP, and %LAA can reliably categorise COPD into phenotypes like emphysema predominant, airway predominant, or mixed, which serve as a guide for patient management.

keywords:

COPD, pulmonary emphysema, chronic bronchitis, spirometry

references:
Milne S, King GG. Advanced imaging in COPD: insights into pulmonary pathophysiology. J Thorac Dis 2014; 6: 1570-1585.
Brillet PY, Fetita CI. Investigation of airways using MDCT for visual and quantitative assessment in COPD patients. Int J Chron Obstruct Pulmon Dis 2008; 3: 97-107.
Yamashiro T, Moriya H, Tsubakimoto M, et al. Continuous quantitative measurement of the proximal airway dimensions and lung density on four-dimensional dynamic-ventilation CT in smokers. Int J Chron Obstruct Pulmon Dis 2016; 11: 755-764.
Orlandi I, Moroni C, Camiciottoli G, et al. Chronic obstructive pulmonary disease: thin section CT measurement of airway wall thickness and lung attenuation. Radiology 2005; 234: 604-610.
Jindal SK, Malik SK. Smoking index – a measure to quantify cumulative smoking exposure. Lung India 1988; 6: 195-196.
GuerraS, Sherrill DL, Bobadilla A, et al. The relation of body mass index to asthma, chronic bronchitis and emphysema. Chest 2002; 122: 1256-1263.
Stratelis G, Fransson SG, Schmekel B, et al. High prevalence of emphysema and its association with BMI: a study of smokers with normal spirometry. Scand J Prim Health Care 2008; 26: 241-247.
Jain NK, Thakkar MS, Jain N, et al. Chronic obstructive pulmonary disease: does gender really matter? Lung India 2011; 28: 258-262.
Boschetto P, Miniati M, Miotto D, et al. Predominant emphysema phenotype in chronic obstructive pulmonary. Eur Respir J, 2003; 21:450–4.
Gupta PP, Yadav R, Verma M, et al. High-resolution computed tomography features in patients with chronic obstructive pulmonary disease. Singapore Med J 2009; 50: 193.
Matsuoka S, Yamashiro T, Washko GR, et al. Quantitative CT assessment of chronic obstructive pulmonary disease. Radiographics 2010; 30: 55-66.
Yanai M, Sekizawa K, Ohrui T, et al. Site of airway obstruction in pulmonary disease: direct measurement of intrabronchial pressure. J Appl Physiol 1992; 72: 1016-1023.
Gurney JW, Jones KK, Robbins RA, et al. Regional distribution of emphysema: correlation of high-resolution CT with pulmonary function tests in unselected smokers. Radiology 1992; 183: 457-463.
Tiddens HA, Pare PD, Hogg JC, et al. Cartilaginous airway dimensions and airflow obstruction in human lungs. Am J Respir Crit CareMed 1995; 152: 260-266.
King GG, Muller NL, Whittall KP, et al. An analysis algorithm for measuring airway lumen and wall areas from high-resolution computed tomographic data. Am J Respir Crit Care Med 2000; 161: 574-580.
Saba OI, Hoffman EA, Reinhardt JM. Maximizing quantitative accuracy of lung airway lumen and wall measures obtained from X-ray CT imaging. J Appl Physiol 2003; 95: 1063-1075.
Laura Pini, Valentina Pinelli, Denise Modina, et al. Central airways remodeling in COPD patients, Int J Chron Obstruct Pulmon Dis 2014; 9: 927-933.
Hasegawa M, Nasuhara Y, Onodera Y, et al. Airflow limitation and airway dimensions in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006, 173: 1309-1315.
Patel B, Make B, Coxson HO, et al. Airway and parenchymal disease in chronic obstructive pulmonary disease are distinct phenotypes. Proc Am Thorac Soc 2006; 3: 533.
 
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