• Respiration · Jan 2012

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

    • Silvestro Ennio D'Anna, Roberto Asnaghi, Gaetano Caramori, Lorenzo Appendini, Manfredi Rizzo, Carmelo Cavallaro, Giorgio Marino, Francesco Cappello, Bruno Balbi, and Antonino Di Stefano.
    • Fondazione San Raffaele, IRCCS, Cefalù, Italy.
    • Respiration. 2012 Jan 1;83(5):383-90.

    BackgroundThe literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction.ObjectivesWe correlated HRCT scores of emphysema with different indices of airflow obstruction.MethodsWe 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(1)% predicted) 52.3 ± 17.6; post-bronchodilator FEV(1)% predicted 56.5 ± 19.1; FEV(1)/forced vital capacity (FVC) ratio 50.8 ± 10.2; post-bronchodilator FEV(1)/FVC ratio 51.6 ± 11.0; percent diffusion lung capacity for carbon monoxide (DLCO%) 59.2 ± 21.1; DLCO/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.ResultsThe 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(1)/FVC ratio before and after bronchodilator use (R = -0.44, p = 0.002, and R = -0.39, p = 0.005), DLCO% (R = -0.64, p = 0.0003) and DLCO/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 DLCO/VA% and HRCT scan score (p = 0.007).ConclusionsThese 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.Copyright © 2011 S. Karger AG, Basel.

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