The correlation between HRCT phenotypes and spirometric indices in patients with COPD
Keywords:COPD, CT phenotypes, GOLD scoring, CT scoring
Background: chronic obstructive pulmonary disease (COPD) is a preventable and treatable inflammatory respiratory disease that is a leading cause of morbidity and mortality worldwide.
Aims: to investigate COPD phenotypes by HRCT, and to compare these phenotypes and other CT findings with the severity of lung function test variables.
Patients and Methods: a cross-sectional, observational study was performed on 56 patients with COPD of any duration and smoking history referred to the radiology department of Al-Imamain Al-Kadhimein Medical city, during the period from 1st of May, 2019 to 31st of December, 2019. PFT (pulmonary function test) was performed at the same visit during which chest HRCT was imaged and these images were interpreted by two independent radiologists and findings were evaluated according to the modified Bhalla scoring system.
Results: from 56 patient included in the study, 47 patients exhibited morphological CT changes while 9 had no pathological findings. Patient with HRCT changes were classified into three phenotypes: Emphysema dominant (n=19), airway dominant (n=18) and mixed phenotype (n=10). With the exception of forced expiratory volume in 1 second to forced vital capacity ratio (FEV1/FVC), other spirometric variables including severity stages termed as global initiative for chronic obstructive lung disease (GOLD) showed no significant correlation with the correspondent phenotypes. While HRCT findings including those scored according to modified Bhalla system were correlated to the CT phenotypes (p- value< 0.001). On the other hand, GOLD severity showed to have no correlation with presence or severity of morphological lung changes detected on HRCT (P- value= 0.4).
Conclusion: the study revealed that GOLD stages of COPD severity based on spirometry have no correlation with radiological phenotypes recognized on CT or the severity of those morphological changes and on the other hand found the close relationship between COPD phenotypes characterized on CT and the severity of morphological abnormalities.
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