scholarly journals Phenotyping of Chronic Obstructive Pulmonary Disease Using the Modified Bhalla Scoring System for High-Resolution Computed Tomography

2013 ◽  
Vol 20 (2) ◽  
pp. 91-96 ◽  
Author(s):  
Baykal Tulek ◽  
Ali Sami Kivrak ◽  
Seda Ozbek ◽  
Fikret Kanat ◽  
Mecit Suerdem
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Resolution ◽  
Pulmonary Disease ◽  
Scoring System ◽  
Morphological Changes ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease

BACKGROUND: Identifying different phenotypes of chronic obstructive pulmonary disease (COPD) is important for both therapeutic options and clinical outcome of the disease.OBJECTIVE: To characterize the phenotypes of COPD according to high-resolution computed tomography (HRCT) findings; and to correlate HRCT scores obtained using the modified Bhalla scoring system with clinical and physiological indicators of systemic inflammation.METHODS: The present study included 80 consecutive patients with stable COPD. HRCT scans were evaluated by two independent radiologists according to the modified Bhalla scoring system.RESULTS: Fifty-four patients exhibited morphological changes on HRCT examination while 26 had no pathological findings. Patients with HRCT findings had lower spirometric measurements and higher levels of inflammation, and reported more exacerbations in the previous year compared with patients with no findings on HRCT. Patients with morphological changes were classified into one of three groups according to their HRCT phenotype(s): emphysema (E) only, E + bronchiectasis (B)/peribronchial thickening (PBT) or B/PBT only. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, C-reactive protein (CRP) levels and the number of exacerbations among the groups were significantly different. Pairwise comparisons between the E only and E+B/PBT groups showed significantly lower FVC, FEV1and FEV1/FVC values, and higher CRP levels and number of exacerbations compared with the B/PBT group. No significant differences were found between the E+B/PBT and the B/PBT groups. An inverse correlation was found between the total HRCT score and FVC, FEV1and FEV1/FVC; the correlation was positive with CRP level, erythrocyte sedimentation rate and number of exacerbations.CONCLUSION: The present study exposed the intimate relationship between phenotype(s) characterized by HRCT and scoring for morphological abnormalities; and clinical and functional parameters and inflammatory markers. The inclusion of HRCT among routine examinations for COPD may provide significant benefits both in the management and prognosis of COPD patients.

scholarly journals High resolution computed tomography in chronic obstructive pulmonary disease

2018 ◽  
Vol 5 (5) ◽  
pp. 1222
Author(s):  
Pragati Rao D. ◽  
Aruna Talatam ◽  
Chakradhar B. ◽  
Bhargavi K. ◽  
Bhagyaraj A.
Keyword(s):  
Computed Tomography ◽  
Chronic Obstructive Pulmonary Disease ◽  
High Resolution ◽  
Pulmonary Disease ◽  
Morbidity And Mortality ◽  
Chronic Obstructive ◽  
X Rays ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterised by persistent respiratory symptoms and airflow limitation with varied presentations (bronchitis and emphysema). High resolution computed tomography (HRCT) plays an important role in identifying the various morphologies thereby reducing morbidity and mortality. The aim of the present study was to evaluate the role of high resolution computed tomography in COPD patients. The Objectives of the present study was to differentiate emphysema predominant, airway predominant and mixed phenotypes and to identify other disease processes and complications.Methods: 50 COPD patients attending Respiratory medicine Department, NRI general hospital were advised for chest x-rays and pulmonary function tests. All the patients selected were smokers with no other co-morbid illnesses. Those patients whose chest x-rays showed no other changes except for COPD changes were selected for HRCT chest.Results: Out of 50 COPD patients emphysema predominance was present in 28 patients (56%), bronchitis predominance in 19 patients (38%) and 3(6%) patients had mixed pattern. In emphysema centriacinar pattern was commonly seen (42.9%), paraseptal in 35.71%, panacinar in 3.57% and bullae in 17.8% cases. All the patients were chronic smokers with pack years >20. All are males with average age above 45 years. Emphysema was common in elderly patients with age above 50 years. Chronic bronchitis is predominantly seen in the age group 40-50 years. Additional diagnoses like bronchiectasis, mass, ILD were identified in 28% cases.Conclusions: HRCT plays a significant role in COPD patients in differentiating phenotypes which have different modes of therapy. Other subtle changes in lungs which cannot be identified on chest x ray are discernible on HRCT. Early identification of complications reduces morbidity and mortality.

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