TITLE:
Computed Tomography Features of Pulmonary Emphysema at the Bouaké Centre for Medical Imaging and Analysis: A Series of 105 Cases
AUTHORS:
Malick Soro, Akouba Grace Assie, Brou Lambert Yao, Sara Carole Sanogo, Dogo Hermann Bélé, Yah Céline Yao, Bouassa Davy Mélaine Kouakou, Allou Florent Kouadio, Kesse Emile Tanoh, Kouamé Paul Bon-Fils Kouassi, Issa Konate
KEYWORDS:
Pulmonary Emphysema, Computed Tomography, Chronic Obstructive Pulmonary Disease, Pulmonary Tuberculosis, Côte d’Ivoire
JOURNAL NAME:
Open Journal of Medical Imaging,
Vol.16 No.4,
October
27,
2026
ABSTRACT: Introduction: Emphysema is one of the two major pathological components of chronic obstructive pulmonary disease (COPD), and its characterisation relies on chest computed tomography (CT). As existing guidelines are based on cohorts of smokers from high-income countries, data from sub-Saharan Africa remain limited. The aim was to describe the CT features of pulmonary emphysema and their associations with clinical presentations and associated lesions. Methods: A retrospective, descriptive study with an exploratory design was conducted at the Bouaké Centre for Medical Imaging and Analysis (Côte d’Ivoire) from January 2020 to December 2024. The 986 chest CT reports from this period were reviewed. The types of emphysema were defined according to the Fleischner Society classification, with paracicatricial emphysema reported separately. Associations were analysed using the chi-squared test or Fisher’s exact test, with crude, unadjusted odds ratios (OR). Results: Emphysema was reported in 139 of 986 examinations (14.1%); 105 patients met the analysis criteria: 93 men and 12 women (sex ratio 7.75), with a median age of 72 years (interquartile range 68 - 78). Respiratory symptoms were the primary presenting complaint (45.7%). Centrilobular emphysema was the most common type (41.0%), followed by paraseptal (31.4%), paracicatricial (20.0%) and panlobular (13.3%). At least one associated lesion was present in 83.8% of patients: interstitial syndrome (54.3%), bronchiectasis (29.5%) and pulmonary fibrosis (24.8%). Centrilobular emphysema was associated with referral for COPD assessment (OR = 11.61; 95% CI: 2.44 - 55.18; p Conclusion: Emphysema was found approximately one in seven chest scans and was rarely isolated. The role of paracicatricial emphysema, a recognised entity defined by its relationship to scarred areas rather than by acinar topography, suggests a lesion profile specific to this context and justifies the adoption of a structured chest scan report.