High-resolution computed tomography in assessment of patients with emphysema

Respir Care. 2013 Apr;58(4):614-22. doi: 10.4187/respcare.01691.

Abstract

Objective: To assess whether high-resolution computed tomography (HRCT) variables are as good as other known clinical variables in grading emphysema patients.

Methods: A detailed clinical history was taken and physical examination performed. We performed serum study, lung function testing, and HRCT scanning to assess emphysema. Mean lung density, the attenuation value separating the least 15% of pixels (PERC15), the percentage of the relative area of the lungs with attenuation values < -950 Hounsfield units (HU) (RA950), and histogram analysis were calculated from computerized data.

Results: The final analysis was based on data from 92 subjects, and they were moderately emphysematous (mean lung density was -877 ± 23 HU, PERC15 was -953 ± 21 HU, and RA950 was 16 ± 5%). There was a significant difference regarding subjective emphysema severity in the St George's Respiratory Questionnaire, smoking history, FEV1, C-reactive protein, age, and body mass index (P < .001). There was a significant correlation between the 3 objective image variables and the 6 objective clinical variables (St George's Respiratory Questionnaire, smoking history, FEV1, C-reactive protein, age, and body mass index) (P < .001).

Conclusions: This study shows the possible important role of HRCT in the diagnosis and quantification of pulmonary emphysema.

Keywords: emphysema; emphysema severity; high-resolution computed tomography; mean lung density.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • C-Reactive Protein / metabolism
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Emphysema / blood
  • Pulmonary Emphysema / diagnosis*
  • Pulmonary Emphysema / physiopathology
  • Reproducibility of Results
  • Respiratory Function Tests
  • Risk Factors
  • Severity of Illness Index
  • Smoking
  • Tomography, X-Ray Computed*

Substances

  • C-Reactive Protein