TY - JOUR T1 - A functional and radiological multiparametric approach to the study of parenchymal features of chronic obstructive pulmonary disease JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P655 AU - Riccardo Inchingolo AU - Giuseppe Corbo AU - Andrea Smargiassi AU - Giulia Patricelli AU - Giuseppe Macis AU - Anna Rita Larici AU - Michele Amato AU - Salvatore Valente Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P655.abstract N2 - Chronic obstructive pulmonary disease (COPD) includes a range of changes ranging from chronic bronchitis to emphysema.We evaluated if integration of lung function tests and computed tomography (CT) scan allows a better characterization of patient with COPD.23 patients (5 females) underwent lung function test and six-minute walk test (6mWT).We used a third-generation, continuous-rotation helical 64-rows CT scanner with volume acquisition to measure extent of emphysema (per cent and absolute value) at full inspiration and at the end of forced expiration.The extent of emphysema corresponding to lung volume with attenuation between -950 and -1024 HU at TLC [Emphysema Index TLC (EITLC)] and RV [Emphysema Index RV (EIRV)] was evaluated.EITLC was 1.21 ± 0.96 L whereas EIRV was equal to 0.76 ± 0.57 L and CT measurements of lung volumes were directly related to static lung volumes.Both EITLC and EIRV were related to the ratios FEV1/FVC, FEV1 (% of predicted), TGV, RV and TLC.Emphysema extent was explained by multiple regression model:EIRV = – 2.12 + 0.02 × ΔAaO2 + 0.29 × TGV + 0.05 × Expiratory time + 0.28 × Sex (r2 = 0.75, p = 0.0001)EITLC = – 3.00 + 0.04 × ΔAaO2 + 0.38 × TLC + 0.31 × Sex (r2 = 0.49, p = 0.0064).Patients with both EITLC and EIRV > median value of each index showed the emphysema extent related to FEV1/FVC, FEF25-75% and mean SpO2 during 6mWT.Emphysema, assessed by CT scan, could be explained by lung function measurements reflecting lung hyperinflation and the impairment of pulmonary gas exchange. Emphysema extent, indipendent of lung volume, is related to indices of expiratory flow limitation. ER -