• K Sashidhar, Madhu Gulati, D Gupta, S Monga, and S Suri.
• Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
• Acta Radiol. 2002 Jan 1;43(1):60-5.

PurposeTo determine the severity and extent of emphysema in heavy smokers by high-resolution CT (HRCT) and to correlate the findings with spirometric tests (STs) and symptomatology.Material And MethodsFifty adult smokers with a mean age of 53 years with a smoking history of more than 30 pack years and normal chest radiographs underwent HRCT of the chest and ST (FEV1, FEV1/FVC, PEFR). Among these, 22 had symptoms of pulmonary disease and 28 were asymptomatic. Quantification of emphysema was done using a density mask program and the visual scoring method. The results were correlated with ST and symptomatology.Results58% (29 out of 50) of the subjects had significant emphysema on HRCT. Eleven out of 15 with normal ST showed emphysema on HRCT while 2 with airflow obstruction on ST showed normal CT scores. 14% (4 out of 28) asymptomatic subjects had severe emphysema compared to 64% of symptomatic subjects. Emphysematous changes were predominantly seen in upper lung zones in 48% of the patients while in 52% it was distributed equally in both upper and lower zones. The number of pack years of smoking showed a positive correlation with CT scores. The correlation between HRCT scores and ST was statistically significant.ConclusionA significant number of asymptomatic and clinically undiagnosed smokers tend to have significant emphysema. HRCT helps in early detection of disease and thus helps implementation of preventive measures.

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