Publication: The correlation of airway obstruction and emphysema on high resolution computed tomography (HRCT) thorax with spirometry in severe chronic obstructive pulmonary disease (COPD)
Date
2022
Authors
Othman, Syahida Sh
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Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease which involves both pulmonary and extrapulmonary components. The pulmonary component is due to airflow limitation, due to parenchymal destruction (emphysema), and airway changes that is partially reversible and usually progressive. Although spirometry is the gold standard to diagnose and assess COPD, but it is unable to provide a comprehensive assessment of the complexity of the disease. On the other hand, high-resolution computed tomography (HRCT) is able to determine the structure involved either airway or parenchymal and extent of lung damage. Thus, this study was conducted to evaluate HRCT thorax parameters in severe COPD patients and correlate with spirometric parameters. Methods: A retrospective cross-sectional study was conducted in Hospital Universiti Sains Malaysia (USM), Kota Bharu, Kelantan, Malaysia with 34 patients who were diagnosed with severe COPD and underwent spirometry and HRCT thorax. The HRCT images were evaluated for airway changes and emphysema at upper, middle and lower lung fields. Pearson Correlation Coefficient was used to determine correlation between FEV1% predicted with airway parameters and emphysema scores. Results: Majority of patients involved in this study comprise of smokers 91.2% (31 patients) and dyspnoea 73.5% (25 patients). Spirometry results showed the mean of FEV1% predicted was 42.2 with standard deviation of 6.84. There was no correlation between airway parameters and emphysema score grading with the FEV1%. In our study, the worse affected area was the upper lobe and majority suffer from Centriacinar emphysema. Conclusion: Our study showed no correlation between airway parameters with FEV1% predicted or emphysema score grading. The other parenchymal changes such as fibrosis and bullae were also present in certain patients which was the likely cause of severe GOLD stage other than emphysema or airway obstruction. Thus, it is imperative that we should consider a combination of spirometry and HRCT Thorax, to diagnose as well as assess the extent of lung damage and provide timely and effective treatment for these patients.
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Keywords
Airway wall thickness , emphysema