6533b7d5fe1ef96bd1265135

RESEARCH PRODUCT

High-resolution computed tomography quantitation of emphysema is correlated with selected lung function values in stable COPD

Manfredi RizzoCarmelo CavallaroLorenzo AppendiniSilvestro Ennio D'annaRoberto AsnaghiBruno BalbiFrancesco CappelloGaetano CaramoriGiorgio MarinoAntonino Di Stefano

subject

MalePulmonary and Respiratory MedicineEmphysema COPD High-resolution computed tomography Lung structural alterationsVital capacityHigh-resolution computed tomographyPulmonary diseaseLung structural alterationsSeverity of Illness IndexPulmonary Disease Chronic ObstructiveFEV1/FVC ratioSeverity of illnessmedicineHumansCOPDLung volumesLung functionHigh-resolution computed tomographyAgedEmphysemaCOPDmedicine.diagnostic_testbusiness.industryChronic obstructive pulmonary diseaseSmokingrespiratory systemmedicine.diseaseBronchodilator AgentsRespiratory Function Testsrespiratory tract diseasesPulmonary EmphysemaAnesthesiaMultivariate AnalysisFemaleTomography X-Ray ComputedbusinessNuclear medicineChronic obstructive pulmonary disease; Emphysema; High-resolution computed tomography; Lung structural alterations;

description

<b><i>Background:</i></b> The literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction. <b><i>Objectives:</i></b> We correlated HRCT scores of emphysema with different indices of airflow obstruction. <b><i>Methods:</i></b> We performed HRCT of the chest in 59 patients, all smokers or ex-smokers, with stable chronic obstructive pulmonary disease of different severity [GOLD stages I–IV; mean age ± SD 67.8 ± 7.3 years; pack/years 51.0 ± 34.6; percent predicted forced expiratory volume in 1 s (FEV<sub>1</sub>% predicted) 52.3 ± 17.6; post-bronchodilator FEV<sub>1</sub>% predicted 56.5 ± 19.1; FEV<sub>1</sub>/forced vital capacity (FVC) ratio 50.8 ± 10.2; post-bronchodilator FEV<sub>1</sub>/FVC ratio 51.6 ± 11.0; percent diffusion lung capacity for carbon monoxide (DL<i>C</i><i>O</i>%) 59.2 ± 21.1; DL<i>C</i><i>O</i>/percent alveolar volume (VA%) 54.5 ± 18.2; percent residual volume 163.0 ± 35.6; percent total lung capacity (TLC%) 113.2 ± 15; residual volume/TLC 1.44 ± 0.2]. All patients were in stable phase. <b><i>Results:</i></b> The mean ± SD visual emphysema score in all patients was 25.6 ± 25.4%. There was a weak but significant correlation between the percentage of pulmonary emphysema and numbers of pack/years (R = +0.31, p = 0.024). The percentage of emphysema was inversely correlated with the FEV<sub>1</sub>/FVC ratio before and after bronchodilator use (R = –0.44, p = 0.002, and R = –0.39, p = 0.005), DL<i>C</i><i>O</i>% (R = –0.64, p = 0.0003) and DL<i>C</i><i>O</i>/VA% (R = –0.68, p < 0.0001). A weak positive correlation was also found with TLC% (R = +0.28, p = 0.048). When patients with documented emphysema were considered separately, the best significant correlation observed was between DL<i>C</i><i>O</i>/VA% and HRCT scan score (p = 0.007). <b><i>Conclusions:</i></b> These data suggest that in patients with stable chronic obstructive pulmonary disease of varying severity, the presence of pulmonary emphysema is best represented by the impaired gas exchange capability of the respiratory system.

yearjournalcountryeditionlanguage
2012-01-01
10.1159/000329871http://hdl.handle.net/11392/1552207