Detection of emphysema with computed tomography: Correlation with pulmonary function tests and chest radiography

Academic Article

Abstract

  • We studied 60 male patients who had concurrent chest films (CXR), computed tomography scans (CT) and pulmonary func-tion tests (PFT) to assess the sensitivity of CT and conventional films in detecting emphysema compared with PFT. We also sought to determine whether emphysema could be diagnosed by CT in patients with normal pulmonary function. Using a method similar to that proposed by Bergin, we scored the severity of emphysema depicted by CT, and using arterial deficiency and bullae as criteria, we estimated the degree of emphysema on CXR. There was a significant inverse correlation between CT scores for emphysema and percentage predicted values of DLCO/VA (r = -0.650), FEV1 (r = -0.552), and FVC (r = -0.409), (P < 0.001). A significant but smaller correlation also was noted with the CXR scores and percentage predicted: DLCO/VA (r = -0.564), FEVi (r =-0.454), and FVC (r = -0.355), (P < 0.005). When decreased diffusion capacity and airway obstruction were used as functional criteria of emphysema, CT was as sensitive as PFT and more sensitive than CXR in detecting emphysema (96% vs. 68%). There was CT evidence of emphysema in 69% (24/35) of patients who did not have functional findings of emphysema. In 12 pathologic specimens available for review, 11 had emphysema by CT and pathologic examination; one patient had centrilobular emphyin detecting emphysema and more sensitive than conventional radiography. CT may be more sensitive than PFT in detecting mild emphysema. Early noninvasive diagnosis of emphysema may provide greater understanding of its natural history and provide an impetus in altering risk factors in asymptomatic patients. © Lippincott-Raven Publishers.
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    Digital Object Identifier (doi)

    Author List

  • Sanders C; Nath PH; Bailey WC
  • Start Page

  • 262
  • End Page

  • 266
  • Volume

  • 23