الفهرس | Only 14 pages are availabe for public view |
Abstract Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and is the 12th leading cause of disability in the world. It is defined in functional terms as a slowly progressive disorder characterized by airflow limitation that does not change markedly over several months. Multi-detector computed tomography (MDCT) has been used for the diagnosis of COPD with favorable results. MDCT scanners provide noninvasive methods to study lung pathology in COPD. The purpose of the study was to assess the role of MDCT in patients with COPD. This was a prospective study conducted during the period from 1st September 2021 to 1st February 2022 on 30 patients who were clinically suspected of COPD and were referred to the Radiology Department of Tanta Insurance Hospital for further assessment by multi-detector computed tomography of the chest. The important findings of this study were the followings: The age of patients ranged from 40 to 78 years with a mean ± SD of 61.4 ± 8.1 years, and the majority of patients aged from 60 to 70 years old. Also, we found that males were more predominant than females (80% vs 20%, respectively). Smoking is the dominating risk factor for COPD in our study representing 76.7%. According to CAT score, 50% of COPD patients recorded high CAT scoring and the 50% reported severe CAT scoring. According to the modified dyspnea scale, the majority of COPD patients were classified as Grade 3, followed by Grade 4 and Grade 2, representing 60%, 30%, and 10%, respectively. Pulmonary function tests ratio (PFT) ranged from 49% to 66% with a mean ± SD of 57.0 ± 4.2%. MDCT demonstrated characteristic findings of COPD, including increased pulmonary vasculature, bronchial wall thickening, lung hyperinflation, increased the anteroposterior diameter of the chest, Barrel chest, irregularity of Bronchovascular markings, elongated trachea, flatting of diaphragm, para-septal emphysema, and centrilobular emphysema. Using MDCT, the right lung density measurement was as follows, upper lobe with a mean ± SD (-909.9 ± 57.4), middle lobe with a mean ± SD (-904.1 ± 49.3), and lower lobe with a mean ± SD (-854.0 ± 49.8) while the left lung density measurement was as following, upper lobe with a mean ± SD (-926.0 ± 61.0), left lingula with a mean ± SD (-904.8 ± 49.3) and lower lobe with a mean ± SD (- 866.1 ± 42.6). COPD patients were classified phenotypically into airway dominant, emphysema dominant, and mixed, representing 50%, 30%, and 20%, respectively. We reported that MDCT is significantly able to differentiate between the three phenotypes. There were significant positive correlations between PFT and upper, middle, and lower lobes of the left lung densities while no correlation between PFT and lung density was detected on the all lobes of right lung. We found a statistically significant association between lung density and COPD phenotype was reported (p<0.001). There was a statistically significant difference between airway phenotype and both emphysema (p= 0.0002) and mixed (p= 0.026) phenotypes as regards lung density. While no statistically significant difference between emphysema phenotype and mixed phenotype regarding lung density. |