TITLE:
Emphysema versus Chronic Bronchitis in COPD: Clinical and Radiologic Characteristics
AUTHORS:
Wafaa Ali Hassan, Eman Abo-Elhamd
KEYWORDS:
COPD, Chronic Bronchitis, Chest X-Ray, CT
JOURNAL NAME:
Open Journal of Radiology,
Vol.4 No.2,
April
4,
2014
ABSTRACT: Background and Objectives:
In clinical practice, spirometry plays a key role in the diagnosis of chronic
obstructive pulmonary disease (COPD), however, it provides no information about
structural pulmonary abnormality. The aim of this study
was to evaluate whether there is a relation between the clinical criteria and chest
radiography or CT studies in differentiating chronic bronchitis from emphysema
in COPD. Patients and methods: In a prospective study, data analysis on 165 COPD
subjects who were enrolled between September, 2011 and December 2012 was completed.
Data were collected including clinical characteristics of stable COPD, pulmonary
function tests, chest X-ray and multidetector computerized tomography (MDCT) findings.
Results: Emphysema was diagnosed in 90 (55%)
of 165 CT scans. The median emphysema score was 58 (range 48 - 72) and significantly
correlated with lower FEV1 values (r = 0.542, p = 0.003). In chronic bronchitis, bronchial wall thickening
was diagnosed approximately as often in chest radiography (56%) as in CT (64%) as
a major finding. Body mass index (BMI), forced expiratory volume in the first second
(FEV1), and diffusion capacity of the lung for carbon monoxide
(DL,CO) were significantly
lower, whereas total lung capacity (TLC) was higher in patients with emphysema.
Cardiovascular diseases and obstructive sleep apnea syndrome (OSAS) were more
common in chronic bronchitis group. Conclusions: Chest radiography is a valuable,
inexpensive means of diagnosing emphysema or bronchial wall thickening in chronic
bronchitis. Emphysematous patients show a worse pulmonary function and a greater
dyspnea. Greater comorbidity in chronic bronchitis may require specific treatment
strategies in this subgroup.